CT Spine is a layered scan of the vertebral column using X-rays. It is a more informative examination method compared to conventional radiography. During the procedure, many longitudinal and transverse “slices” of the spine are obtained in the lateral and anteroposterior projections. It is prescribed for injuries, developmental abnormalities, degenerative, inflammatory and tumor processes of the spinal column.
Due to its high information content and accessibility, CT spine is widely used in the diagnosis of various diseases and to assess the results of their treatment. X-ray tomography allows to determine the cause of compression of the spinal cord (tumors, intervertebral hernias), to identify anomalies in the development of the spine, structural changes of the vertebrae (osteoporosis, fractures, deformities, osteophyte formation), infectious processes, hematomas, abscesses, calcification foci. The technique is indicated for traumatic injuries of the spinal column, suspected primary tumor or metastases, for the diagnosis of persistent pain syndrome, for assessing the condition of the spine after spinal cord injury or surgical treatment. In neurology, CT spine is used mainly to study the bone structures of the spinal column, less often – to diagnose spinal cord pathology, intervertebral hernias, abscesses and hematomas.
Indications for CT spine are:
- back pain, sometimes with irradiation to the sternum, upper or lower extremities;
- signs of cerebral circulation disorders;
- spinal column deformity;
- back injuries;
- weakness, impaired motor function of the arms and legs;
- paresthesia and limb cramps;
- restriction of mobility of one or several parts of the spine.
The contrast procedure shows the state of the vascular system, allows you to diagnose neoplasms of small diameter. With the introduction of an iodine solution, the structure of soft tissue formations is clearly visible in the pictures, inflammatory foci are highlighted.
With the help of computed tomography of the spine , it is revealed:
- hernias, protrusion of intervertebral discs are detected;
- hematomyelia (hemorrhages in the cavity of the spinal canal);
- fractures, cracks of vertebral bodies and spinous processes;
- ruptures of ligaments, muscles, hemorrhages in the soft tissues of the back;
- multiple sclerosis;
- benign and malignant neoplasms;
- displacement of vertebral bodies relative to each other;
- congenital malformations of the spine;
- compression lesions of spinal nerve roots;
- pathological bends of the spinal column.
To study the structure of the blood plexuses located in the soft membrane of the spinal cord, contrast scanning is performed. As a result, vascular pathologies are diagnosed:
- stenosis, thrombosis, embolism of vertebral veins and arteries;
- violation of the integrity of the vascular wall in injuries;
- Acute violation of cerebral blood supply;
- vascular tumors (hemangiomas);
- congenital anomalies of the structure of the bloodstream (malformations, pathological tortuosity, etc.);
- compression of the spinal cord in hematomyelia.
The preparation of the patient and the principles of the procedure are similar to those of computed tomography of other anatomical formations. Special training is necessary in the study of the lumbar spine. In this case, within a few days before the scan, the patient takes enzyme preparations and activated charcoal to clean the intestines, immediately before the start of the manipulation, a cleansing enema is put.
Computed tomography visualizes changes in the structure of the anatomical formation. The spine performs supporting, shock-absorbing, motor and protective functions. A complex joint is formed by 33-34 bone elements connected by a ligamentous apparatus. Inside the spinal column there is a channel containing cerebrospinal fluid and cerebral substance. Paired nerve roots depart from the spinal cord. Depreciation is carried out by cartilaginous layers (discs). With the development of the pathological process, structural disorders, anomalies in the shape and size of morphological elements occur. CT shows:
- density, uniformity, height of cartilaginous discs;
- the size, shape, location of the vertebrae;
- patency of the spinal canal;
- the condition of the main blood vessels (cervical scanning);
- features of the structure of the ligamentous apparatus, back muscles.
With the help of computed tomography of the spine, the localization, size, and stage of development of the pathological process are determined. As a result of the scan, oncological, degenerative, demyelinating diseases, inflammatory changes in the back tissues are detected. The pictures clearly show structural anomalies, violation of the integrity of the morphological elements of the joint.
Computed tomography of the spine shows the slightest violations of the structure and functionality of the articular elements. A three-dimensional image in preparation for surgery allows you to localize the pathological process, clarify the scope of the upcoming operation.
Computed tomography involves the effect of X-rays on the patient’s body. The radiation load at MSCT is insignificant. Sanitary and hygienic standards have been developed, compliance with which ensures the safety of the health of the subject. A radiation load not exceeding 5 mSv (millisieverts) is permissible per year. On average, it is allowed to undergo 2 CT scans of the spine for 12 months.
The child’s body reacts more acutely to the effects of ionizing radiation. The age limit for the appointment of a native CT is 5 years. Intravenous injections of a contrast agent to a child are provided in a hospital setting. From the age of 12, restrictions are lifted, it is possible to carry out computed tomography in specialized centers in compliance with security measures.
Absolute contraindications to CT spine:
- pregnancy – ionizing currents have a teratogenic effect on the fetus;
- radiation sickness and other pathologies that exclude the possibility of using X-rays.
- When using contrast, the list of restrictions expands:
- iodine intolerance – allergic reactions are possible;
- hyperthyroidism – contrast injection leads to increased symptoms of thyrotoxicosis;
- renal insufficiency – when removing the “staining” solution, the load on the filtration organs increases;
- diabetes mellitus in the treatment of Metformin – the simultaneous use of an iodine-containing drug with the named agent increases the concentration of lactic acid in the tissues.