Establishing the correct diagnosis is an important milestone in patient care.
The lumbosacral region combines:
- five vertebrae of the lumbar spine,
- five fused sacral vertebrae,
- from three to five completely fused coccyx vertebrae.
There are no discs in the sacrum and coccyx. The lumbosacral region sometimes has exceptions to the rules in its structure.
In the sacrum, it happens that the first vertebra did not fuse with the next vertebra and became independent. In this case, it is called the sixth lumbar. This increase in the lumbar spine is called ” lumbarization “.
It happens when the last lumbar vertebra is fixed motionlessly to the sacrum, becoming the first sacral vertebra. This phenomenon is called “sacralization”. The cases described are considered normal.
Clinicians view the lumbosacral area as one area for diagnosis.
What is an MRI of the lower back
MRI examination of the lumbosacral spine is the most modern, painless and precise method. Shows the state of all tissues in the field of diagnosis and the relative position of the elements of the department.
The diagnostic method is in demand in orthopedics, oncology, neurosurgery. The high information content of the images, the ability to create a volumetric picture allows specialists to look inside the lumbosacral area.
MRI at the site of the lesion is performed in transverse and sagittal projections. The device makes cross sections for the study of the problem area with a step of three millimeters. In the part of the spine where there are discs, the slices are oriented parallel to their location.
Contrasting is done if there is a suspicion of a tumor.
What diseases does this diagnosis show?
Tomography shows all diseases caused by displacement of discs, vertebrae and changes in tissues:
- ankylosing spondylitis,
- neoplasms and metastases,
- narrowing of the spinal canal,
- congenital anomalies of the spine,
- changes in the spinal cord of an inflammatory and infectious nature,
- traumatic disorders,
- coccygeal cyst.
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Indications for magnetic resonance imaging of the lumbosacral spine
Diagnostics are prescribed for:
- pain, numbness in the legs,
- discomfort and pain in the lumbosacral region,
- before and after surgery,
- if there is a suspicion of a tumor,
- to make sure that the treatment is effective,
- if it is necessary to clarify the diagnosis when conducting other studies,
- with previously established diseases of the lumbosacral region – to observe changes in the state,
- with injuries.
The method does not carry hazardous radiation for the patient. The magnetic field has some peculiarities, so there are slight restrictions.
- The presence of metal objects, implants in the body serves as a prohibition on MRI. Metal inclusions under the influence of a magnet can move and cause injury.
- The devices built into the body, supporting its functions, are also an obstacle to the procedure.
- Claustrophobia if there is a closed-type tomograph in a hospital.
- The effect of the magnetic field on the fetus during pregnancy has not yet been sufficiently studied. Warming up is known to occur, so no MRI is done during the first trimester.
- Children under seven years of age are conditionally included in the list of contraindications, because they cannot lie without moving during the procedure. If necessary, the study is connected with sedatives.
- If the patient has diseases in which he is not able to spend the time of the procedure in immobility.
Preparation for the procedure
Before the procedure, the doctor can give special recommendations for preparation.
On the eve of the study it is necessary:
- if contrast agent is used, do not eat four hours before the procedure,
- get rid of metal objects,
- cards, leave the phone outside the zone of influence of the tomograph.
The procedure is performed without discomfort for the patient:
- The man lies down on the installation table.
- The table drives into an open or closed tomograph.
- Some devices make noise during the examination. If desired, the patient can use ear plugs or vacuum headphones.
The duration of the procedure is fifteen minutes, up to thirty minutes in case of contrasting.
Factors that affect the cost of the survey:
- The research equipment has different modifications. Since the moment of its invention, more and more new developments have appeared.
- In specific cases, the procedure time may vary.
Computed tomography of the spine – informative diagnostics of all tissues
Computed tomography is a breakthrough in medical diagnostics. The radiography that existed before this reflects the organ, but does not show small details about the pathology.
This is due to the imperfection of the method, the image consists of the sum of the overlays of all tissues, one by one, that fell under the X-ray. Best of all, it reflects the airways and bones.
A computed tomograph is an ultra-modern device that allows you to scan X-ray sections of the body with a predetermined program step, for example, one millimeter (layer-by-layer diagnostics).
The computer processes the information and provides a three-dimensional image of the organ with the exact location and nature of the pathology. Gives a picture in the transverse plane of the fabric, which was not available with the previous methods.
The sensitivity of the equipment is fifty times higher than that of its predecessor – classical radiography. This means that the information content of the study is incomparably more capacious. Pictures carry complete information about all kinds of body tissues, including soft ones.
What is computed tomography of the spine for?
For effective treatment, it is important to diagnose the problem as accurately as possible.
Computed tomography makes it possible to:
- To see a digital snapshot of the general view of the problem area or the entire spine, sections highlighting the details of the disease.
- In addition to the state of the vertebrae and discs, their anatomical location, it shows the state of the surrounding tissues.
- A picture will be seen whether changes have occurred in the nerve fibers, cells of the spinal cord and muscles of the spine. If there are violations, then the study gives one more clarification – whether they are irreversible.
- The attending physician will receive comprehensive information about the problem with the spine and will be able to make an accurate prescription.
What diseases of the spinal column helps to show
- Disorders associated with intervertebral discs will reveal osteochondrosis.
- If similar changes in two or more parts of the spine are common osteochondrosis.
- The study allows you to determine the presence of the consequences of osteochondrosis – herniated intervertebral discs and narrowing of the spinal cord canals, which leads to injury to the nerve and disruption of the organs for which it is responsible.
- Complications associated with osteochondrosis – osteophytes are diagnosed.
- The device can detect any deviations from the norm in the vertebrae, discs and surrounding tissues:
- spine defects from birth,
- spinal injury.
Indications for diagnostics
The study is prescribed by a doctor in most cases when it is necessary to clarify the diagnosis before prescribing a course of treatment.
The direct reason is:
- The need to assess the condition of the disks.
- Examination of the vertebral bodies for the content of mineral salts.
- Making a diagnosis for unclear systematic pain in the back, head, arms and legs.
- Determination of the consequences of a spinal injury.
- After simpler studies, for example, X-ray, if it became necessary to clarify the diagnosis.
- To determine if the treatment is effective.
The CT scan procedure is painless and harmless. Exposure to X-rays is insignificant.
- Contraindication is pregnancy and early childhood. This rule is neglected when urgently needed. If an urgent examination of a pregnant woman is still required, the fetus is covered with a lead screen.
- When conducting a study with a computer tomograph (16-slice), a contraindication is the patient’s weight over one hundred and fifty kilograms. The latest development, a spiral 64-slice tomograph, limits the weight of the examined person to 227 kilograms. The new model produces more gentle radiation during examination, which makes it possible to diagnose children.
- Contraindications include severe renal failure.
Computed tomography of the spine does not require any preparatory actions with a few exceptions.
- If a contrast material is injected during diagnosis. In this case, they are kept from eating for six hours before the procedure. The liquid is discontinued one hour before the diagnosis.
- When examining the lumbosacral region, do not eat foods leading to gas formation per day. On the evening before the study day, it is necessary to empty the intestines.
How the examination is done
The patient lies with his back on the tomograph table. If necessary, the position of the body is secured with belts and rollers so that involuntary movements do not occur.
During the procedure, the table is moved inside the tomograph. A ring with an X-ray unit revolves around it. The tomograph makes a little noise.
The duration of the study takes three minutes, with the use of contrast – twenty-five minutes. The patient receives the processed diagnostic results one and a half hours after the end of the procedure.
What is better to have a CT scan of the spine or MRI
For the patient, the examinations are similar in appearance. Various physical phenomena are embedded in their actions. Sometimes computed tomography and magnetic resonance imaging are performed , they complement each other. The doctor determines which diagnosis is preferred in a particular case.
Bone structures are better diagnosed with computed tomography. Magnetic resonance imaging is more informative when examining soft tissues. It is used to diagnose children and pregnant women, because the method is completely harmless.