Diagnosing Spinal Fracture

Patients—and even their doctors—often dismiss back pain as being a normal part of aging. But for those who have a weakened spine due to bone loss or other conditions, back pain could be a symptom of spinal fracture. Because spinal fractures often go undiagnosed, it’s important to talk to your doctor about your risk for spinal fracture. Receiving early treatment is important.

Sometimes you can feel pain from spinal fracture, but it may not show up on an X-ray for several weeks. If your doctor doesn’t find a spinal fracture on the initial X-ray, but you have persistent back pain with no clear cause, consider asking for a second imaging study, such as an MRI.

Diagnostic Tools for Diagnosing Spinal Fracture

Below are the various diagnostic tools your doctor may use to diagnose spinal fracture:

X-ray

An X-ray is a non-invasive imaging process that uses photographic film to absorb electromagnetic radiation transmitted through a material body. These images, also known as radiographs or roentgenograms, are used to diagnose and monitor the treatment of various disorders.

CT-Scan

Computerized axial tomography is commonly referred to as a CT scan. It is a painless imaging technique that uses a computer to produce detailed three-dimensional images of a body from a collation of cross-sectional X-rays taken along an axis. Of all the imaging techniques that are currently available, the CT scan is best able to produce images of bone, blood, and soft tissue.

MRI

MRI stands for magnetic resonance imaging. It is a non-invasive imaging technique that involves rotating a magnet around the body and exciting its hydrogen atoms. A scanner is then used to detect the energy emitted by the excited atoms. MRI is a very useful tool available for diagnosing spinal disorders.

Myelogram

A myelogram involves injecting a radiographic contrast dye into the sac (dura) surrounding the spinal cord and nerves, and then taking X-rays of the spine. This allows the radiologist to target and visualize the nerve roots. Abnormalities within the spinal canal can potentially be identified to aid in the diagnosis of certain spinal problems, such as nerve compression or disc rupture.

Discography

Discograms may be done to establish whether the disc is the mechanism causing back or radicular pain. This exam is generally done in the lumbar spine, but may occasionally be performed in the cervical region. The procedure may be done in the radiology suite by a radiologist or in the operating room by a surgeon. Fluoroscopy is used to ensure proper placement of the spinal needle into the disc. Radiopaque dye is then injected into the disc nucleus. In a normal disc the dye will be contained within the central nucleus. If the dye leaks out of the nucleus into the surrounding tissue, then the disc is considered to be abnormal.

Bone Scan

A bone scan involves intravenously injecting a small quantity of a radiographic marker into the patient, and then running a scanner over the area of concern. The scanner detects the marker, which concentrates in any region exhibiting high bone turnover. A bone scan is used when there is suspicion of tumor, infection, or small fractures—all conditions that result in high bone turnover. A bone scan doesn’t replace the above tests, but may provide additional information by eliminating other serious problems.

DXA Scan

A DXA (Dual-energy X-ray Absorptiometry) scan measures bone mineral density to check for possible bone loss. During the test, the patient lies fully clothed on a padded table while the DXA scanner beams X-rays from two sources toward the bone being examined (usually the lower spine or hip). A radiation detector device is slowly passed over the examination area, producing images that are projected onto a monitor. A computer then analyzes the images and calculates bone density based on the amount of radiation absorbed by the bone (the denser the bone, the more radiation it absorbs).

The test is performed by a doctor or technician and requires no injections, sedation, special diet or any other advance preparation. The procedure can take up to 30 minutes.