Patient Education

We have included this Patient Education section on our website to provide you with valuable information which you can use to help answer any questions you may have. 

Please don't hesitate to call us with any questions or concerns at (405) 949-1800.

Diagnositic tests-Xray, MRI, CT, Myelogram, EMG/NCS

Spinal X-Ray       

An X-ray is a diagnostic test that images bones by shooting an X-ray beam through the body. The calcium in bones blocks penetration of the X-ray beam and the image of the bones is picked up as a shadow on a film positioned on the other side of the patient. X-rays provide for excellent bony detail because bone consists mainly of calcium. X-rays of the spine can be used to diagnose tumors, fractures, and spinal misalignment. However, discs and nerve roots do not have any calcium, so an X-ray does not capture an image of these structures. An X-ray cannot be used to diagnose lumbar disc herniation or other causes of nerve pinching.

Why are spinal X-ray's are done?

They may be taken to check the curve of your spine (scoliosis), spinal defects or to find injuries or diseases that affect the discs or joints in your spine. These problems may include spinal fractures, infections, dislocations, tumors, bone spurs, or disc disease. Xrays will also be done to check changes after spinal surgery.

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI) is a test that uses a magnetic field and pulses of radio wave energy (not radiation) to make pictures of organs and structures inside the body. In many cases, MRI gives different information about structures in the body than can be seen with a X-ray, ultrasound or computed tomography (CT) scan. MRI also may show problems that cannot be seen with other imaging methods.

For an MRI test, the area of the body being studied is placed inside a special machine that contains a strong magnet. Some patients may feel claustophobic and there are open MRI machines that don't enclose your entire body but the pictures are not optimal for surgerical decision making. See your physician for help with any anxiety you may feel about having a MRI performed. An MRI test usually takes 30 to 60 minutes but can take as long as 2 hours depending on the area of the body being scanned. 

Why are MRI's Done?

MRI's are used to find problems such as tumors, bleeding, injury, blood vessel diseases, or infection. MRI also may be done to provide more information about a problem seen on an X-ray, ultrasound, or  CT scan.

An MRI scan can be done for the:

*Head. MRI can look at the brain for tumors, an aneurysm, bleeding in the brain, nerve injury, and other problems, such as damage caused by a stroke. MRI can also find problems of the eyes and optic nerves, and the ears and auditory nerves.

*Bones and joints. MRI can check for problems of the bones and joints, such as arthritis, problems with the temporomandibular joint, bone marrow problems, bone tumors, cartilage problems, torn ligaments ortendons, or infection. MRI may also be used to tell if a bone is broken when X-ray results are not clear. MRI is done more commonly than other tests to check for some bone and joint problems.

*Spine. MRI can check the discs and nerves of the spine for conditions such as spinal stenosis, disc bulges, and spinal tumors.

Computed Tomography (CT/CAT Scan)

A computed tomography scan allows doctors to see inside your body. It uses a combination of X-rays and a computer to create pictures of your organs, bones, and other tissues. CT images of internal organs, bones, soft tissue and blood vessels typically provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels. Using CT, the bony structure of the spinal vertebrae is clearly and accurately shown, as are the intervertebral disks and to some degree, the spinal cord.

During the test, you’ll lie on a table inside a large, doughnut-shaped CT machine. As the table slowly moves through the scanner, the X-rays rotate around your body. How long the scan takes will depend on what parts of your body are being scanned. It can take anywhere from a few minutes to a half-hour.

Why is it done?

*evaluate the spine before and after surgery.

*help diagnose spinal pain. One of the most common causes of spinal pain that may be diagnosed by CT is a herniated intervertebral disk. Occasionally, this diagnosis is made using CT myelography.

*accurately measure bone density in the spine and predict whether vertebral fractures are likely to occur in patients who are at risk of osteoporosis.

*assess for congenital anomalies of the spine or scoliosis.

*detect various types of tumors in the vertebral column, including those that have spread there from another area of the body. Some tumors that arise elsewhere are first identified by finding deposits of malignant cells (metastases) in the vertebrae; prostate cancer is an example.

*guide diagnostic procedures such as the biopsy of a suspicious area to detect cancer, or the removal of fluid from a localized infection (abscess).

In patients with narrowing (stenosis) of the spinal canal, vertebral fracture, infection or degenerative disease such as arthritis, CT of the spine may provide important information when performed alone or in addition to magnetic resonance imaging (MRI).

 

Myelogram

A myelogram uses X-rays and a special dye called contrast material to make pictures of the bones and the fluid-filled space (subarachnoid space) between the bones in your spine (spinal canal). The spinal canal holds the spinal cord, spinal nerve roots, and the subarachnoid space. A myelogram may be done to find a tumor, an infection, problems with the spine such as a herniated disc, or narrowing of the spinal canal caused by arthritis.

During the test, a dye is put into the subarachnoid space with a thin needle. The dye moves through the space so the nerve roots and spinal cord can be seen more clearly. Pictures may be taken before and after the dye is used. To get more information from the test, a CT scan is often done after the X-rays, while the dye is still in your body. A myelogram can help find the cause of pain that cannot be found by other tests, such as an MRI or a CT scan. 

Why It Is Done?

A myelogram is done to check for:

*The cause of arm or leg numbness, weakness, or pain.

*Narrowing of the spinal canal (spinal stenosis).

*A tumor or infection causing problems with the spinal cord or nerve roots.

*A spinal disc that has ruptured (herniated disc).

*Inflammation of the membrane that covers the brain and spinal cord.

*Problems with the blood vessels to the spine. 

Electromyogram and nerve conduction studies (EMG/NCS). 

Your doctor might use these tests to see if any nerves are damaged or compressed. The EMG test uses a device to detect the tiny amount of electricity muscle cells make when they're stimulated by nerves connected to them. A needle electrode placed into a muscle records its electrical activity and looks for anything that isn’t as it should be.

The NCS test is often done at the same time as the EMG. In this test, the nerves are stimulated with tiny electrical impulses by an electrode at one point on the body while other electrodes detect the impulses at a different point. The time it takes for the electrical impulses to travel between electrodes lets your doctor know whether there is nerve damage.

*The definitions above were found on www.radiologyinfo.org and www.webmd.com. Please visit the websites or ask a staff member for a more detailed description of the testing listed above.