CT of the lumbar spine is an excellent method of evaluating the patient with back pain.
With a state of the art modern multi-slice CT scanner, fine slices are taken as the patient enters the scanner. The images are then produced and can be reconstructed from any angle, without having to scan the patient again. As such, an accurate diagnosis may be confidently made.
Further to this, the images may be rendered to produce a 3-D effect.
Common conditions include disc bulges, which compresses a nerve. This commonly results in leg pain, a condition often referred to as “sciatica”.
If the pain does not respond to physiotherapy and medications, then a CT guided nerve root injection, delivering a small dose of cortisone may be of benefit.
Of course, an MRI may also be used to evaluate back pain, which has the advantage over CT in that it well demonstrates the nerves in the spinal canal (MRI image 7). In this case, the patient has a developmental defect which results in forward slipping of the L5 vertebral body (“spondylolisthesis") and therefore disruption of the disc. The condition may result in both localised back and leg pain.
View related articles: