At Novant Health Total Spine Specialists, we understand how unpleasant uncertainty can be, and we work to put an end to that uncertainty as quickly as possible. We have a complete range of diagnostic tools aimed at uncovering the source of your back pain, neck pain or sciatic nerve pain so that our physicians can determine what courses of treatment could help you.
Our goal is to find the treatment option right for you, regardless of whether that treatment is a nonsurgical procedure such as therapy or pain management, minimally invasive surgery or traditional surgery.
Among the diagnostic testing tools we regularly use:
An X-ray is used to take a picture of the spine or a bone. X-rays can be helpful in diagnosing spinal fractures, as well as infections or tumors in the spine. X-rays can show the space between your vertebrae, bone spurs or abnormalities in joints. X-rays are not always the best way to see soft tissues including nerves, discs and ligaments. Since X-rays are completely non-invasive, they are often one of the first diagnostic tools used to provide an overview of the spine. To learn more about X-rays of the spine, neck and back, please click here.
An MRI, which stands for Magnetic Resonance Imaging, uses magnetic and radio waves to create an image on a computer. MRIs can scan the soft tissues of the spine to reveal abnormalities of musccles, nerves and ligaments as well as bones. This test can reveal disc problems including degeneration even in the very early stages. The results of an MRI are often used in conjunction with results from an X-ray or CT scan to give your doctor a complete picture of your spine. Click here to learn more about MRIs of the spine.
A CT scan, or "CAT" scan, is a type of X-ray used to view bone and soft tissue. CAT stands for Computer Assisted Tomography. A computer interprets X-rays as if they were slices through the body. Software is used to combine these images into a three-dimensional view of the spine or a bone, along with the nearby muscles, fat and organs. This diagnostic tool can show if bone spurs are pushing against spinal nerves, or if the spine has been damaged by an infection or cancer. CT scans can be done with or without contrast. Contrast is a substance taken by mouth or injected into a certain body part so that part can be seen more clearly. CT scans are often used in conjunction with MRI or X-ray results to provide a more complete picture of a spinal problem. Please click here for more information about spinal CT scans.
Often, the body will respond to a problem in the spine or another bone by speeding up production of new bone to repair the problem. During a bone scan, a radioactive chemical called a "tracer" is injected into the bloodstream. The chemical attaches itself to areas of the skeleton where new bone is growing. Pictures taken with a special camera a few hours after the injection show areas where the "tracer" has settled, indicating potential locations of fractures and other problems. The "tracer" disappears from the bloodstream very quickly. To learn more about the bone scan procedure, please click here.
A myelogram is a test used to examine the spinal cord and spinal canal. A dye placed in the spinal sac through a spinal tap travels through the spine and shows up on X-rays to outline the spinal cord and nerve roots. This helps identify abnormal indentations or shapes within the spinal cord including herniated discs, tumors or abnormalities resulting from injury. Since the spinal tap is an invasive procedure, your doctor will likely use this test only if more details are needed after an MRI or CT scan. Click here to learn more about what to expect during the myelogram procedure.
A discogram is an advanced X-ray used to examine injured spinal discs. This test can determine which disc is damaged and whether it is the source of pain. It can reveal if a disc has started to rupture, or has tears through its outer rings. Dye is injected into the center of the injured discs to make them show up clearly. That fluid also can increase the pressure in the disc, allowing the doctor to see how the patient reacts to that pressure; pain is only felt with certain types of disc damage. The results of the X-ray and the patient's reaction to pain can help determine what procedure would be best to treat the problem and the pain.
Facet joint block
Facets are joints between vertebrae in the spine. They can cause pain if irritated or inflamed. A facet joint block is both a test and a treatment. It involves injecting a local anesthetic into the affected facet joint, or into the nerve branches going to the facet joint. Medication including cortisone might then be injected into the facet joint to decrease inflammation and possibly take pain away. This offers only temporary relief, and the block only works if it targeted the correct joint or nerve.
Nerve testing, or Nerve Conduction Velocity Testing (NCV), is used to see if nerves are functioning and carrying messages through the body correctly. It can help diagnose a nerve injury, including weakness or numbness in the arms or legs, or it can show how a nerve is responding to treatment. Small electrodes placed on the skin stimulate nerves, while other receptors are used to measure how quickly impulses travel through nerves. The current is strong enough to possibly make skin tingle, but is not enough to be dangerous. Click here to learn more about nerve testing.