Resurgens Orthopaedics

Greater Atlanta's Premier Spine Center

X-Rays

Spinal X-rays are pictures of the spine to find injuries or diseases that affect the discs or joints in the spine.  These include spinal fractures, infections, dislocations, tumors, bone spurs, or disc disease.  Spinal X-rays are also done to check the alignment or curvature of the spine and to evaluate for deformity of the spine (scoliosis) or for spinal instability.
 

What Is an X-Ray?

X-rays are a form of radiation, like light or radio waves, that are focused into a beam, much like a flashlight beam.  X-rays can pass through most objects, including the human body.  

How Do X-Rays Create a Picture?

X-rays make a picture by striking a detector that either exposes a film or sends the picture to a computer.  The pictures created are often called X-rays, but technically the films are called radiographs.  Dense tissues in the body, such as bones, block (absorb) many of the X-rays and look white on an X-ray picture.  A bone abnormality is reflected on the finished film.  Less dense tissues, such as muscles and organs, block fewer of the X-rays (more of the X-rays pass through) and look like shades of gray on an X-ray.  X-rays that pass only through air look black on the picture.  Shades of gray mirror the density of the different tissues.  X-rays are best for looking at bone.  They are not helpful for looking at soft trauma.

 

When Were X-Rays Developed?

In 1895, Wilhelm Conrad Roentgen discovered the x-ray.  Roentgen did not entirely understand these unusual rays.  He used the letter "x" to describe the rays because in Algebra "x" refers to an unknown.

 

Why are X-Rays Performed?

An abnormal X-ray may give a physician an idea about what may be causing a patient’s pain, but the majority of x-rays in patients with back and neck pain are normal.  The most common causes of low back pain, such as strained back muscles or ligaments, do not show up on a spinal X-ray.  The main purpose of plain x-ray is to detect serious underlying structural or pathologic conditions.

An x-ray may rule out particular problems involving bone and some soft tissue disorders.  When an x-ray proves inconclusive, additional tests may be ordered especially if something suspicious is detected. 

Spinal X-rays have been used by some employers to screen healthy people for possible future back problems.  Most health professionals do not believe that this is appropriate.  If a potential employer wants you to have a spinal X-ray before you can start working, you may want first to discuss the matter with the employer and your doctor.

 

X-Rays can detect the following:
  • Arthritis of the joints between the vertebrae and the breakdown (degeneration) of the discs between the spinal bones.
  • Injuries to the spine, such as fractures or dislocations.
  • Changes in the spine from other problems, such as infections or tumors.
  • Abnormal curvatures of the spine, such as scoliosis.
  • Abnormal motion in the spine, or spinal instability, such as in spondylolisthesis.
  • Changes in the spine after spinal surgery.

 

What Can Not Be Seen on X-Ray?
  • Strained or inflamed muscles or ligaments
  • Bulging, protruding, or herniated (ruptured) spinal discs
  • Stenosis, or narrowing of the spinal canal
  • Pinched nerves

Other tests, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a myelogram, may provide more information about these conditions than a spinal X-ray.

 

What are the Risks?

There is always a slight risk of damage to cells or tissue from being exposed to any radiation, including the low levels of radiation used for this test.  The risk of damage from the X-rays is usually very low compared with the potential benefits of the test.            

During a single x-ray exposure, a patient is exposed to approximately 20 milliroentgens of radiation.  We are all exposed to approximately 100 milliroentgens of radiation each year from sources like the ultraviolet rays of the sun and small traces of radioactive isotopes, such as uranium, in the soil.  For example, the radiation exposure from a chest X-ray is about equal to the natural radiation exposure received during a round-trip airline flight from Boston to Los Angeles. 

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant.  If this is the case, in most situations, x-rays will not be performed until it is determined whether you are pregnant, or until the pregnancy is completed.  While the vast majority of medical x-rays do not pose a critical risk to a developing child, there may be a small likelihood of causing a serious illness or other complication.  The actual risk depends on how far along the pregnancy is and on the type of x-ray.  If a cervical spine X-ray is absolutely necessary, such as in cases of severe neck trauma, a lead apron will be placed over your abdomen to shield the fetus from exposure to the X-rays.