Spondylography is a study of the bones and joints of the spinal column throughout. It provides information about the condition and structure of the vertebrae, assess the distance between the vertebrae, study their processes, intervertebral joints and openings, determine the mobility of individual vertebral segments, the nature and degree of curvature of the spine. The state of cartilage structures and the spinal cord can be judged by some indirect signs. Spondylography can be survey or sighting, conventional or with functional tests.
Spondylography in neurology is used to determine the causes of neurological disorders in congenital anomalies, pathological curvatures and traumatic injuries of the spinal column. The technique is prescribed to assess the size of the spinal canal, detect signs of tumor and inflammatory lesions of the spine, diagnose osteochondrosis and clarify the severity of degenerative-dystrophic changes, establish the cause of circulatory insufficiency in the vertebral-basilar basin of the brain.
In patients with clinical manifestations of osteochondrosis, radiography can detect displacement of vertebrae, deformation of their bodies, reduction of intervertebral distances, proliferation of osteophytes, arthrosis of intervertebral joints, instability, indirect signs of the presence of herniated discs. On the X-ray it is impossible to see tumors of the spinal roots and the spinal cord itself, but it is possible to judge them by some bone changes. Thus, the destruction of the vertebral bodies indicates the presence of a metastatic tumor, the expansion of the intervertebral foramen indicates a neurinoma of the spinal root, the local expansion of the spinal canal and the destruction of the vertebral arches indicates an extramedular tumor process.
Usually the indications relate to one part of the spine: cervical, thoracic or lumbosacral. When determining the indications for radiography in the thoracic and lumbosacral regions, the doctor takes into account that the procedure is associated with irradiation of the abdominal cavity and pelvis. Multiple images of this zone are considered impractical, if necessary, repeated manipulations are recommended to replace the method with other studies, if possible. X-ray is not performed during pregnancy and when the patient is unable to remain motionless due to neurological or mental illnesses. Sedation can be used to ensure the patient’s immobility during the procedure.
Patient preparation is required when examining the coccyx, lumbar or sacral spine. It consists in a complete cleansing of the intestines, since gas bubbles and intestinal contents can give shadows that overlap with the main image and complicate diagnosis. A few days before the manipulation, the patient should refuse to eat products that promote gas formation (white bread, cabbage, dairy products, etc.). To cleanse the intestines these days, enzymes and activated charcoal should be taken. On the eve of the examination, it is necessary to refrain from eating, make a cleansing enema.
Methodology of conducting
Spondylography is carried out according to the general scheme of X-ray examination. The patient is in a lying or standing position. The pictures are taken in direct and lateral projections. If necessary, use additional oblique projections. Targeted radiographs of individual segments of the spine are possible. In addition, images with functional samples are used to assess the mobility of the segment under study.