CT Scan
This is a x-ray based scanning device that looks at the bones of the spine in greater detail with cross-sectional views. This test is performed to assess spinal cord anatomy, explore causes of back pain, detect any type of tumors and help the physician plan any necessary surgical interventions. CT scanners are very fast and can scan in just a few minutes.
CT Myelogram
This test involves the placement of a needle into the spinal fluid where contrast dye is injected. X-rays are then taken at various times and in different positions as the contrast dye outlines the spinal cord and the nerves. This test helps to assess herniated discs, spinal canal narrowing and tumors. Following the test, the patient will remain on critical bedrest and will be instructed to remain on light activity for a period of time after returning home.
It is very important that a complete list of medications is provided by the patient prior to the test. Aspirin, Coumadin, Lovenox and Heparin products must be stopped prior to a myelogram.
Discogram
This is a controversial test that involves injections, performed by a pain specialist, into the disc space to investigate the shape of the disc and to determine if that disc is the cause of the pain the patient is experiencing. As medicine is injected into the disc space, the patient is asked to describe the sensation. If the injection reproduces the patient’s primary complaint, it identifies the disc as the area of concern. This test may be ordered to further investigate the need for a surgical intervention, but the results are subjective and therefore controversial. A CT scan follows the discogram.
EMG
This test measures the electrical discharges made by the muscles and how well your nerves transmit these signals. This test is important to detect and evaluate the source of any nerve damage, the severity of the damage and the recovery from a nerve injury. This test does involve the placement of small needles through the skin into the muscles being evaluated.
DEXA (Duel Energy X-Ray Absorptiometry)
This is a noninvasive test performed on the back and the hips to look for osteoporosis (link to osteoporosis in condition section) or thinning of the bones. This is used to determine a patient’s risk of developing fractures and to look at the bone quality prior to surgery.
MRI
This is a test that does not involve radiation, but requires the patient to be enclosed in a tube that can sometimes bother people with claustrophobia. This test allows visualization of the spine, as well as the discs, spinal cord and the spaces through which the nerves pass. The test is performed to assess spinal cord anatomy, act as a guide for injections of pain medications, explore causes of pain, better assess the discs and help the physician plan any necessary surgical interventions. The MRI may require contrast, such as gadolinium, so the patient needs to be sure to alert the physician of any allergies to contrast. This test is used more frequently in patients that have had spinal surgery in the past. Of note, open MRI is available for those patients with claustrophobia. Dr. Taylor feels the closed MRI offers improved image quality compared to open MRI studies.
* Of note, gadolinium does not contain iodine