When a physician is treating a patient with severe and persistent neck or back pain, a herniated disc may be suspected. The spinal discs provide cushioning between the vertebrae. A herniation means that the soft, gel-like center of the disc is pushing through the outer ring and pressing on nearby nerves. Although the problem may be the result of some type of injury or trauma, degeneration of the discs often occurs with aging.
A herniated disc may cause severe and persistent pain, limited mobility, muscle spasms, and neurological symptoms including tingling, weakness, and numbness. A herniated disc in the cervical spine may cause radiating pain into the shoulder and down the arm. A herniated disc in the lumbar spine may cause radiating pain and numbness into the buttocks and down the leg to the foot.
What is the best imaging test for diagnosing herniated discs?
The gold standard for diagnosing herniated discs is an MRI. MRIs show soft tissues including discs, nerves, and the spinal cord. X-rays show the vertebrae of the spine and the spaces for discs, but they do not show detail of the soft tissues. A herniation will not be seen on an x-ray. A CT scan is a series of x-rays taken from different directions that combine to create cross-sectional images. While they may show a herniation, MRIs provide better soft tissue detail.
Do MRIs expose patients to radiation?
Unlike x-rays and CT scans, MRIs do not expose patients to radiation. MRIs use strong magnetic fields and radiofrequency energy. MRIs are generally very safe, and there is no cumulative harm from frequent usage. The test is non-invasive and produces 3-D images of the area being studied. MRIs may be done with or without a contrast material being injected first.
Are MRIs appropriate for all patients?
Some people should not have an MRI due to safety concerns. This includes people with a pacemaker, defibrillator, deep brain stimulator, neuromuscular stimulator, cochlear implant, metallic joint prostheses, aneurysm clips, and implanted drug pumps. People who have metal fragments in their bodies, such as bullets or shrapnel, should not have MRIs. This is because of the possibility of dangerous overheating and damage or malfunction of the devices.
What alternative imaging can be used for patients unable to have an MRI?
People who are unable to have an MRI may be given a CT scan instead. This is the best option for people who have a pacemaker, defibrillator, cochlear implants, or metal implants. CT scans may also be a more comfortable alternative for people with severe claustrophobia who would be uncomfortable in an enclosed MRI tube. However, CT scans do expose people to radiation, and they provide less detailed images than an MRI.
Atlanta Brain and Spine Care
The neurosurgeons at Atlanta Brain and Spine Care are experts in the diagnosis of neck and back pain. Contact us to schedule an appointment with a spine specialist.
