X-ray examination and CT examination of spinal diseases

There are many auxiliary examinations that can be done for spinal diseases, among which the most widely used and popular is spinal X-ray plain film. X-ray plain film of spine has special significance in clinic and is more popular. Routine examination is more valuable than cT and MRI, which is helpful to judge the curative effect and clarify the nature, scope, degree, classification and staging of lesions. In addition to spine X-ray films, there are many special photography methods, such as tomography, computed tomography (cT), magnetic resonance imaging (MRl), myelography, EEG, electromyography, evoked potentials, etc.

X-ray plain film of spine

Orthoposition: Observe whether there is dislocation of pivot joint, odontoid fracture or absence. Whether the transverse process of the seventh cervical vertebra is too long and whether there are neck ribs. Whether the uncinate joint and intervertebral space are widened or narrowed.

scoliosis

1. Curvature change: cervical vertebra straightens, physiological protrusion disappears or bends back.

2. Abnormal mobility: On the X-ray film of cervical hyperextension and hyperflexion, we can see that the elasticity of intervertebral disc has changed.

3. osteophyte: osteophyte and ligament calcification can be produced in the parts near the intervertebral disc before and after the vertebral body.

4. Narrowing of intervertebral space: Due to the protrusion of nucleus pulposus, the water content of intervertebral disc is reduced, which can make the intervertebral disc thinner, which is manifested as narrowing of intervertebral space on X-ray film.

5. Subluxation and smaller intervertebral foramen: After intervertebral disc degeneration, the stability between vertebral bodies is low, and the vertebral bodies often have subluxation or vertebral body slippage.

6. Calcification of nuchal ligament: Calcification of nuchal ligament is one of the typical lesions of cervical spondylosis.

loxosis

The left and right oblique radiographs of spine are mainly used to observe the size of intervertebral foramen and the hyperosteogeny of uncinate joint.

Electromyography

The EMG of cervical spondylosis and cervical disc herniation is because both cervical spondylosis and cervical disc herniation can make nerve roots degenerate after long-term compression, thus losing the inhibitory effect on the muscles they control. In this way, denervated muscle fibers can spontaneously contract due to the stimulation of a small amount of acetylcholine in the body. Therefore, fiber potentials appear in one or both upper limb muscles, and occasionally a few fascicular fibrillation positions appear. When small force contracts, the polyphase potential is normal and there is no huge potential. When forced to contract, it is completely disturbed. The average duration and average potential of motor unit potential are normal. The amplitude is 1 ~ 2mV. Cervical vertebra leads to extensive degeneration of intervertebral disc and bone hyperplasia. Nerve roots were extensively damaged, and more muscles were denervated. Patients with advanced disease and long course of disease can reduce wave number and amplitude when they contract autonomously. Cervical disc herniation is often a single disc herniation, and its changes are mostly in one upper limb. The denervated muscle range is obviously segmented.

CT examination of spinal diseases

CT has been used to diagnose vertebral arch insufficiency, hyperosteogeny, vertebral burst fracture, ossification of posterior longitudinal ligament, spinal canal stenosis, spinal canal enlargement or bone destruction caused by spinal cord tumor, and to measure bone mineral density to estimate the degree of osteoporosis. In addition, due to the cross-sectional image, the soft tissue and subarachnoid space inside and outside the epidural sheath can be clearly seen. Therefore, it is possible to correctly diagnose disc herniation and neurofibroma. Spinal cord or medullary cavity has certain value in the diagnosis and differential diagnosis of cervical spondylosis.