Discover more about the Harley Street Spine Clinic diagnostic & MRI services via the links below.
Magnetic Resonance Imaging (MRI) uses magnets and radiowaves to construct slice by slice computer images of the inside of a patients body. Images display every relevant tissue including nerve, bone, ligament, disc, etc. Usually these scans take half an hour to perform which involves the patient lying still inside a tunnel, however new machines use seated or open scanners.
Open MRI Scan
Naturally some patients experience claustrophobia when lying down in the tunnel of standard MRI scans. New ‘open’ MRI scan machines no longer include a tunnel but instead use an open bed like an x-ray machine.
Seated / Upright MRI Scan
Another alternative to the traditional MRI scanner are seated MRI scans. As the name implies, rather than lying down scans are performed as the patient is sitting or even standing. This can help reveal problems like disc bulging which is not always evident when the spine isn’t subject to the loading of body weight (such as with standard MRI scans performed with the patient lying down).
3T MRI scan
The latest breed of MRI scans feature “3T” scanning, which gives a better image resolution than older 1.5T scanners.
X-rays whilst being relatively quick and cheap to perform, do involve exposing the patient to an amount of x-ray radiation and can only really show bone tissue. They are mainly used to discover bone fractures, bone infections, bone spikes (osteophytes) and bone tumours. Wear and tear which occurs over time usually appears on x-rays but is often unrelated to a patient’s symptoms. X-rays unfortunately cannot show other structures of the spine that could be injured including ligaments, discs and nerves.
Dynamic (Functional) X-ray
Instead of taking an x-ray whilst the patient is lying down, dynamic functional x-rays are performed with the patient standing, sitting, bending forward and / or bending backwards. This enables us to see extra information on the spine including foraminal volumes, scoliosis, facet joint hypertrophy and osteophytes, prior surgery, gas in the disc, degree of anterior olisthesis, retrolisthesis, spondylolytic spondylolisthesis, pelvic tilt and which segments of the spine are over or under working when moving. This information isn’t always visible when a patient is lying down in a typical x-ray or MRI scan.
Ultrasound scanning can help assess the recruitment of specific deep abdominal (core) muscles which have a supportive role for the spine. Ultrasounds can even assess damage in some ligaments, muscles and tendons which lie close to the skin’s surface, but this particular use is usually reserved for issues with peripheral joints such as the shoulder.
Single Photon Computed Tomography (SPECT) uses a radioactive (tracer) chemical that is injected into the blood stream and attaches to areas of unusual metabolic activity and blood flow, so called “hot spots”. These can indicate sites of pain generation which could have been missed on other diagnostic imaging such as MRI or X-ray. Combining a SPECT scan with a (low field – low radiation) CT scan produces better imaging of a pain generating area giving a complete picture of the issues. Structures such as joint capsule, ligament or disc can be identified as the source of pain. Using this method can help us to provide a precise therapeutic intervention.
Sometimes it’s necessary to refer patients for specialist tests such as blood tests to full differentiate between certain conditions, or nerve conduction tests. The Harley Street Spine Clinic has access to the full range of these tests so that we can find the cause of your problem.