X-rays are very good at detecting new fractures, spondylosis, spinal deformities such as scoliosis, kyphosis, spondylolysis and spondylolisthesis ( instability ) .
CT is most useful when bony abnormality is suspected. Common conditions where CT scan is done are spine fractures, facet arthrosis, spondylosis, spondylolisthesis, pars fractures (spondylolysis) and high BMI patients where quality of x-rays are suboptimal.
MRI is the modality of choice for most spinal conditions. It uses strong magnetic field to create images of the spine. It is very good for looking at the soft tissue structures of the spine such as nerves, spinal cord and intervertebral disc. The best thing about MRI is that it does not involve radiation as its safe for most patients .
MRI is not advised for patients with medical implants such as pacemaker devices, aneurysm clips in the brain, metallic bodies in the eye, Stainless Steel implants.
Yes, Myelogram can be performed on a patient who cannot undergo MRI.
A Myelogram involves the injection of dye into the spinal fluid surrounding the spinal cord and nerves. Erect and dynamic X rays or a CT are then performed. Myelograms detect narrowing around the spinal cord and nerve roots.
Dual energy X-Ray Absorptiometry (DEXA scan) is the test that measures bone density. It measures the bone quality of the patient and compares it to a normal person.
Bone scan can detect the relative biologic activity of a bone lesion. Is advised to screen the skeletal system for metastatic disease, spinal column for metastatic tumour, primary bone tumour, disc space infection, or vertebral osteomyelitis.
X-ray is the simplest form of investigation. Easy to perform in the out patient clinic. X rays are usually performed in standing and bending positions.