TOPIC- SAFE AND LOGICAL RADIOGRAPHY OF L.S.

SPINE

SUBMITTED BY:
S.CHAND
ROLL NO. –
 INTRODUCTION TO SPINE:
• Adult Spine is 72 cm long in Men and 7-10 cm less in Women.
• There are 33 Vertebrae.
• Adult spine consists of Five main region:
• CERVICAL – C1-C7
• THORACIC – T1-T12
• LUMBAR – L1-L5
• SACRAL – S1-S5
• COCCYX – C1-C4
• There are 24 Mobile Segment and 9 Fused Vertebrae which are
immobile.
LEVELS OF SPINES –

CERVICAL – C1-C7
THORACIC – T1-T12
LUMBAR – L1-L5
SACRAL – S1-S5
COCCYX – C1-C4
POSITION AND STRUCTURE OF SPINE:
Types of Bones in Spine:
FUNCTIONS OF SPINE:

Allows Flexibility
in all 6 directions.
• Protection of Spinal Cord, Meninges, Vessels, and Internal Organ
• Provide support and Balance for upright Posture.
INTRODUCTION TO LUMBAR SACRAL
SPINE:
• "Lumbar" is derived from the Latin word "lumbus," meaning lion, and
the lumbar spine earns its name.

• It is built for both power and flexibility - lifting, twisting, and

bending.

• The lumbar spine refers to the lower back, where the spine curves
inward toward the abdomen.

• It starts about five or six inches below the shoulder blades, and
connects with the thoracic spine at the top and extends downward to
the sacral spine.
POSITION OF LUMBAR SPINE:

 Lumbar Intervertebral
Segment

The lumbar spine has 5

intervertebral segments,
termed lumbar segment 1
through 5 (e.g. L1, L2,
L3, L4, and L5).
 THE LUMBO-SACRAL SPINE INCLUDES:

 Lumbar vertebrae:
Numbered L1 through L5, these odd-shaped vertebrae signal the
end of the typical bones of the spinal column.

 Sacrum:
This triangle-shaped bone is made up of five fused vertebrae. It
fits like a wedge into the back of the pelvis at the hips.

 Coccyx:
This small bone is better known as the tailbone.
 CHARACTERISTICS OF LUMBAR SPINE:
• The five vertebrae of the lumbar spine (L1-L5) are the biggest unfused vertebrae
in the spinal column, enabling them to support the weight of the entire torso.
• The lumbar spine's lowest two spinal segments, L4-L5 and L5-S1, which include
the vertebrae and discs, bear the most weight and are therefore the most prone to
degradation and injury.
• The lumbar spine meets the sacrum at the lumbosacral joint (L5-S1). This joint
allows for considerable rotation, so that the pelvis and hips may swing when
walking and running.
• The spinal cord travels from the base of the skull through the spinal column and
ends at about T12-L1 - where the thoracic spine meets the lumbar spine.
• The lower the vertebrae is in the spinal column, the more weight it must bear.
 LUMBAR INTERVERTEBRAL SEGMENT:
Each lumbar spine segment is comprised of:

• Two vertebrae, such as L4-L5, stacked vertically with an intervertebral

disc between them.
• The two adjacent vertebrae are connected in the back of the spine by two
small joints called facet joints. The facet joints of the lumbar spine allow
movement to bend and twist the low back in all directions.
• There are nerves that branch off from the spinal column at each level of
the spine. They pass through small holes in the back of the lower spine.
They then connect together to form the sciatic nerve, which travels into
the legs down the back of each thigh and into the calves and feet.
 INTERVERTEBRAL JOINT:

• Intervertebral joint allows proper functioning of

vertebral column.

• Consists of:
• Vertebral End Plates
• Intervertebral Disc
• Epiphyseal Joint
INTERVERTEBRAL JOINT:
Intervertebral
Discs-

 It protects against
compressive
forces.

 Allow Equal
weight
distribution
ANATOMY OF RADIOGRAPHY OF SPINE
 RADIOGRAPHIC ANOTOMY OF LUMBAR SPINE:
• A lumbosacral spine X-ray, or lumbar spine X-ray, is an imaging test that
helps Doctor’s to view the anatomy of your lower back.
• The lumbar spine is made up of five vertebral bones. The sacrum is the
bony “shield” at the back of your pelvis. It’s located below the lumbar
spine. The coccyx, or tailbone, is located below the sacrum.
• The thoracic spine sits on top of the lumbar spine.
• The lumbar spine also has:
• large blood vessels
• nerves
• tendons
• ligaments
• cartilage
 Why is a lumbar spine X-ray performed?
• An X-ray is a useful test for many conditions. It can help your doctor
understand the cause of chronic back pain or view the effects of injuries,
disease, or infection.

Doctors may order a lumbar spine X-ray to diagnose:

• birth defects that affect the spine
• injury or fractures to the lower spine
• low back pain that's severe or lasts for more than four to eight weeks
• osteoarthritis, which is arthritis affecting the joints
• osteoporosis, which is a condition that causes your bones to thin
• abnormal curvature or degenerative changes in your lumbar spine, such
as bone spurs
• cancer
 RADIOGRAPHIC TECHNIQUES: Imaging tests along with an X-ray
• MRI SCANS –
An MRI scan uses magnets and radio waves to capture images inside your body without
making a surgical incision. The scan allows your doctor to see the soft tissue of your
body, like muscles and organs, in addition to your bones.
• BONE SCANS –
During a bone scan, a radioactive substance is injected into a vein that is taken up by
your bones. You’ll then be monitored for several hours. A very small amount of radiation
is used in the substance, and nearly all of it is released from your body within two or
three days
• ULTRASOUNDS –
The technology is similar to that used by sonar and radar, which help the military detect
planes and ships. An ultrasound allows your doctor to see problems with organs, vessels,
and tissues without needing to make an incision.
• CT SCANS –
In the case of a lumbar spine CT scan, your doctor can see a cross-section of your lower
back. The scanning machine circles the body and sends images to a computer monitor,
where they are reviewed by a technician.
1. MRI SCAN:
An MRI scan uses magnets and radio waves to capture images inside your body
without making a surgical incision. The scan allows your doctor to see the soft
tissue of your body, like muscles and organs, in addition to your bones.
Why a lumbar MRI is done:
Doctor might order a lumbar MRI if you have the following symptoms:
• back pain accompanied by fever
• birth defects affecting your spine
• injury to your lower spine
• persistent or severe lower back pain
• problems with your bladder
• signs of brain or spinal cancer
• weakness, numbness, or other problems with your legs
HOW A LUMBAR MRI SCAN IS PERFORMED:
• An MRI machine looks like a large metal-and-plastic doughnut with a bench that slowly glides
you into the center of the opening. The entire process can take from 30 to 90 minutes.
• If contrast dye will be used, a nurse or doctor will inject the contrast dye through a tube
inserted into one of your veins. In some cases, you may need to wait up to an hour for the dye
to work its way through your bloodstream and into your spine.
• The MRI technician will have you lie on the bench, either on your back, side, or stomach. You
may receive a pillow or blanket if you have trouble lying on the bench. The technician will
control the movement of the bench from another room. They’ll be able to communicate with
you through a speaker in the machine.
• The machine will make some loud humming and thumping noises as it takes images. Many
hospitals offer earplugs, while others have televisions or headphones for music to help you
pass the time.
• As the images are being taken, the technician will ask you to hold your breath for a few
seconds. You won’t feel anything during the test.
THE RISKS OF A LUMBAR MRI SCAN:
• There are risks for people who have implants containing metal. The magnets used in an MRI
can result in problems with pacemakers or cause implanted screws or pins to shift in your body.
• It’s considered a safer alternative, especially for pregnant women and growing children.
Although there are sometimes side effects, they’re extremely rare.
• To date, here have been no documented side effects from the radio waves and magnets used in
the scan.
• Another complication is an allergic reaction to contrast dye. During some MRI examinations,
contrast dye is injected into the bloodstream to give a clearer image of blood vessels in the area
being scanned.
• The most common type of contrast dye is gadolinium. Allergic reactions to the dye are often
mild and easy to control with medication.
2. BONE SCAN:
During a bone scan, a radioactive substance is injected into a vein that is taken up by your
bones. You’ll then be monitored for several hours. A very small amount of radiation is
used in the substance, and nearly all of it is released from your body within two or three
days.
• Why is a bone scan performed: Bone scans may reveal bone problems associated with
the following conditions:
• Arthritis
• Avascular necrosis (when bone tissue dies due to a lack of blood supply)
• Bone cancers
• Cancer, that has spread to the bone from other parts of the body
• Fibrous dysplasia (a condition that causes abnormal scar-like tissue to grow in place of
normal bone)
• Fractures
• Infection involving the bone
• Paget’s disease of the bone (a disease that causes weak, deformed bones)
HOW A LUMBAR BONE SCAN IS PERFORMED:

• The procedure begins with an injection of radioactive substance in your vein. The substance is
then allowed to work its way through your body for the next two to four hours. Depending on
the reason for the bone scan, your doctor may begin imaging immediately.
• As the substance spreads through your body, the bone’s cells naturally gravitate to areas that
need repair. The substance’s radioactive tracers follow these cells and collect in spots where
bone is damaged. It’s taken up in regions that have a high blood flow.
• After enough time has passed, your doctor will use a special camera to scan the bones. The
damaged areas — where the substance has settled — appear as dark spots on the image.
• Your doctor may repeat the injection and imaging process if the first round wasn’t conclusive.
They may also order a single-photon emission computed tomography (SPECT). This is similar
to a bone scan, except the imaging process creates 3-D images of your bones. A SPECT is
necessary if your doctor needs to see deeper into your bones. They may also use it if the original
images weren’t clear in certain areas.
THE RISKS OF BONE SCAN:

• A bone scan carries no greater risk than conventional X-rays.

• The tracers in the radioactive substance used in a bone scan produce very little
radiation exposure.
• The risk of having an allergic reaction to the tracers is low.
• However, the test may be unsafe for pregnant or breastfeeding women.
• There is a risk of injury to the fetus and of contaminating breast milk. Make sure
to tell your doctor if you’re pregnant or breastfeeding.
3. ULTRASOUNDS:
The technology is similar to that used by sonar and radar, which help the military detect planes
and ships. An ultrasound allows your doctor to see problems with organs, vessels, and tissues
without needing to make an incision.

Why an ultrasound is performed:

• Bladder, Brain (in infants), Eyes

• Gallbladder, kidneys, Uterus
• Liver, Pancreas
• Spleen, Testicles
• blood vessels, Thyroid
• An ultrasound is also a helpful way to guide surgeons’ movements during certain medical
procedures, such as biopsies.
HOW AN UNTRASOUND IS PERFORMED:
How an ultrasound is performed:
• An ultrasound technician, called a sonographer, will apply a special lubricating
jelly to your skin. This prevents friction so they can rub the ultrasound transducer
on your skin. The transducer has a similar appearance to a microphone. The jelly
also helps transmit the sound waves.
• The transducer sends high-frequency sound waves through your body. The waves
echo as they hit a dense object, such as an organ or bone. Those echoes are then
reflected back into a computer. The sound waves are at too high of a pitch for the
human ear to hear. They form a picture that can be interpreted by the doctor.
• Depending on the area being examined, you may need to change positions so the
technician can have better access.
• After the procedure, the gel will be cleaned off of your skin. The whole procedure
typically lasts less than 30 minutes, depending on the area being examined. You
will be free to go about your normal activities after the procedure has finished.
4. CT SCAN:
In the case of a lumbar spine CT scan, your doctor can see a cross-section of your lower back. The
scanning machine circles the body and sends images to a computer monitor, where they are reviewed by a
technician.
Why is a Lumbar Spine CT scan performed?
• Back pain accompanied by fever
• Birth defects affecting the spine
• A herniated disk
• Infection
• Injury to the lower spine
• Low back pain
• Osteoarthritis
• A pinched nerve
• Problems controlling the bladder
• Signs of cancer
• Spinal surgery preparation
• Weakness, numbness, or other problems with your legs
HOW A LUMBAR SPINE CT SCAN IS PERFORMED:
• A technician will ask you to lie on your back during the test. The technician may
use pillows or straps to ensure that you stay in the correct position long enough for
a quality image to be obtained. You may also have to hold your breath during brief
individual scans.
• Using a remote from a separate room, the CT technician will move the table into
the CT machine. You may go through the machine several times.
• Depending on the reason for your scan, you may be hooked up to an IV so that
contrast dye can be injected into your veins during the test. This dye helps the
machine take clear images of your blood vessels and organs.
• After a round of scans, you may be asked to wait while the technician reviews the
images to ensure they are clear enough that your doctor can read them correctly.
• A typical CT scan takes between 30 and 45 minutes to complete.
THE RISKS OF CT SCAN:

• A lumbar spine CT scan carries very few risks.

• The contrast dye used during the procedure may cause temporary kidney damage,
though.
• This risk is higher if your kidneys have already been damaged by disease or
infection. Newer dyes carry much less risk to the kidneys.
• As with any X-ray, there’s some exposure to radiation. Although it’s typically
harmless, this is an important issue for women who are pregnant or could be
pregnant.
• The amount of radiation used is considered safe for adults, but not for a
developing fetus and should be used with caution in children.
AFTER A LUMBER SPINE X-RAY:
• After the test, you can change back into your regular clothes and go
about your day right away.

• Your radiologist and doctor will review the X-rays and discuss their
findings. Results from your X-ray may be available the same day or it
take some days.

• Your doctor will determine how to proceed depending on what the X-

rays show. They may order additional imaging scans, blood tests, or
other tests to help make an accurate diagnosis
 ANATOMY OF RADIOGRAPHY SPINE:

PLANES AND DIRECTION FOR RADIOGRAPHY:

• Anterior/ Ventral
• Posterior/ Dorsal
• Cranial
• Caudal
• Medial
• Lateral
• Coronal Plane
• Sagittal
• Axial Plane
 PLANES AND
DIRECTION FOR
RADIOGRAPHY:
RADIOGRAPHY OF LS SPINE- AP/LATERAL/ LATERAL
FLEXION AND LATERAL EXTENSION VIEW
 CONCLUSION:

There are various methods for radiography of LS spine depending

on the illness we prefer the radiographic techniques as mentioned
above.
In mentioned radiographic techniques all the details required like
why it is done and how it is done is mentioned.
All these techniques are mentioned in accordance to the safety and
procedures.
Although, these techniques are improving day by day for the better
treatment of the patients.
THANK YOU !