An X-ray is one kind of imaging test done to assess internal areas of the body. They are less thorough but cheaper than the popular MRI (magnetic resonance imaging) test, which can provide a picture of both the body's soft and hard tissues. X-rays provide a clear picture of bones, whereas softer tissues appear as shades of gray.
An X-ray may be ordered if you have back pain to assess the alignment of your spine, its curvatures, the spaces between vertebrae and the condition of spinal joints. X-rays can also indicate the presence of disc degeneration, infections, tumors and bone spurs in the spine.
Many patients are given the reports of their X-rays without receiving an understandable interpretation of what they mean. People with back pain are left wondering what problems are affecting their spines and how severe they are. Online forums are full of people asking for help interpreting their X-ray results. The following explanations may help you understand what your imaging test indicates.
Spinal Anatomy
First, you must understand how vertebrae are named. The top seven vertebrae beginning at the neck make up the cervical spine. Below this, there are 12 vertebrae composing the thoracic spine, 10 of which connect to the ribs. Below this is the lumbar spine, made up of 5 vertebrae. The sacrum attaches to the bottom lumbar vertebrae; it is a large, triangular bone made up of several bones fused together. The coccyx, or tailbone, sits below the sacrum.
The bones of the spine are named with the first letter of the spine section (C for cervical, T for thoracic and so on) and a number denoting its position in the segment (1 for the highest vertebra, 2 for the next one down and so on).
Next, use the following glossary of medical terms to make sense of your X-ray results.
Glossary
Anterior: The front-most part; closest to the front side of the body
Arthritis: Wearing down of the cartilage that protects bone ends at a joint
Arthrosis: A joint
Degenerative Disc Disease: The general condition of discs wearing down, due to either age or overuse
Disc Space: The amount of space a disc takes up and separates vertebrae by. Decreased space means the disc is degenerating, bulging or herniating.
Facets: Joints that connect vertebrae together in the posterior section of the bones.
Foramen/Neuroforamen: The hole between vertebrae through which nerves within the spinal canal exit to reach other parts of the body
Fracture: A break in the continuity of a bone
Fused: A condition that occurs when two bones literally fuse or grow together.
Kyphosis: Outward curvature, naturally found in the thoracic spine. If kyphosis is lost where it is supposed to be, spinal discs will experience excess posterior pressure.
Lordosis: Inward curvature, naturally found in lumbar and cervical spine segments. If lordosis is lost, spinal discs may experience excess anterior pressure.
Posterior: The back-most part; closest to the back of the body
Retrolisthesis: The backward movement of a vertebra
Sacroiliac Joints: Formed where the large hip bones meet the sacrum on each side at the base of the spine; susceptible to hyper- or hypo-mobility
Sagittal Alignment: The alignment of your spine as seen from the side; assesses where the sacrum is relative to the top cervical spine; can show lordosis or kyphosis
Scoliosis: Sideways curvature of the spine
Spondylitis: Inflammation of the joints between spinal bones
Spondylolisthesis: The forward movement of a vertebra
Spondylolysis: The breaking of a facet joint; could lead to spondylolisthesis
Spur: A small fragment of bone that forms due to injury or prolonged friction between bones
Stenosis: Narrowing of the spinal canal in which the bundle of nerves composing the spinal cord runs; caused by bone spur, disc or anything else protruding into the canal.
Transverse Process: Bony protrusions, one at each side of each vertebra, responsible for attaching ligaments and muscles to the spine.
This glossary should help you understand the results of your X-ray. For more back pain terms, see http://www.spine-health.com/glossary.
If your doctor is unable or unwilling to help you understand the results of your imaging test, you will need to do your own research. Understanding the medical jargon and some basic facts about the spine will put you in a position to be an empowered, informed patient.
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