are a form of radiation, like light or radio waves, that are focused into a
beam, much like a flashlight beam. X-rays can pass through most objects,
including the human body. X-rays make a picture by striking a detector that
either exposes a film or sends the picture to a computer. Dense tissues in the
body, such as bones, block (absorb) many of the X-rays and look white on an
X-ray picture. Less dense tissues, such as muscles and organs, block fewer of
the X-rays (more of the X-rays pass through) and look like shades of gray on an
X-ray. X-rays that pass only through air, such as through the lungs, look black on the picture.
X-rays are pictures of the spine. They may be taken to find injuries or
diseases that affect the
discs or joints in your spine. These problems may include spinal
fractures, infections, dislocations, tumors, bone
spurs, or disc disease.
Spinal X-rays are also done to check the curve of
your spine (scoliosis) or for spinal defects.
The spine is divided into
four parts. So there are four common types of spinal X-rays:
Cervical spine X-ray. This X-ray test takes
pictures of the 7 neck (cervical) bones.
Thoracic spine X-ray. This X-ray test takes
pictures of the 12 chest (thoracic) bones.
Lumbosacral spine X-ray. This X-ray test takes
pictures of the 5 bones of the lower back (lumbar vertebrae) and a view of the
5 fused bones at the bottom of the spine (sacrum).
Sacrum/coccyx X-ray. This X-ray test takes a
detailed view of the 5 fused bones at the bottom of the spine (sacrum) and the
4 small bones of the tailbone (coccyx).
The most common spinal X-rays are of the cervical
vertebrae (C-spine films) and lumbosacral vertebrae (LS-spine films).
Why It Is Done
A spinal X-ray is done to:
Find the cause of ongoing pain, numbness, or
arthritis of the joints between the vertebrae and the
breakdown (degeneration) of the discs between the spinal
Check injuries to the spine, such as fractures or
Check the spine for effects
from other problems, such as infections, tumors, or bone
Check for abnormal curves of the spine, such as
scoliosis, in children or young adults.
Check the spine for
problems present at birth (congenital conditions), such as
spina bifida, in infants, children, or young
Check changes in the spine after spinal surgery.
How To Prepare
Before the X-ray test, tell your
doctor if you are or might be pregnant. The
risk of radiation exposure to your unborn baby (fetus) must be
considered. The risk of damage from the X-rays is usually very low compared
with the potential benefits of the test. If a spinal X-ray is absolutely
necessary, a lead apron will be placed over your belly to shield your baby
from the X-rays.
You may need to take off any jewelry that may be in the way of the X-ray
picture, such as if you have a pierced belly button.
You don't need to do anything else before you have this
Talk to your
doctor about any concerns you have regarding the need for the test, its risks,
how it will be done, or what the results will mean. To help you understand the
importance of this test, fill out the
medical test information form(What is a PDF document?).
How It Is Done
A spinal X-ray is taken by a radiology
technologist. The X-ray pictures are usually read by a doctor who specializes
in reading X-rays (radiologist).
You will need to remove any
jewelry that may be in the way of the X-ray picture. You may need to take off
some of your clothes, depending on which area is examined. You will be given a
cloth or paper gown to use during the test. You may be allowed to keep on your
underwear if it does not get in the way of the test.
X-ray test, you will lie on an X-ray table. If the X-ray is being taken because
of a possibly serious injury to your neck or back, to prevent causing more injury a radiologist will look at
the first X-ray pictures before taking others.
If you have a neck brace (cervical collar) in place, X-ray pictures may be
taken and a physical exam done to see whether the brace can be taken off
without hurting the spine.
Usually 3 to 5 X-ray pictures are
taken. You need to lie very still to avoid blurring the pictures.
A spinal X-ray usually takes about 15 minutes. You will wait about 5
minutes until the X-rays are processed in case more pictures need to be
taken. In some clinics and hospitals, X-ray pictures can be shown right away
on a computer screen.
How It Feels
You will feel no discomfort from the
X-rays. The X-ray table may feel hard, and the room may be cool. You may find
that the positions you need to hold are uncomfortable or painful, especially if
you have an injury.
There is always a slight risk of damage to
cells or tissue from being exposed to any radiation, including the low levels
of radiation used for this test. But the risk of damage from the X-rays is
usually very low compared with the potential benefits of the test.
For example, the radiation exposure from a chest X-ray is about equal to
the natural radiation exposure received during a round-trip airline flight from
Boston to Los Angeles (or Montreal to Vancouver) or 10 days in the Rocky
Mountains (Denver, Colorado).
In an emergency, a doctor can see the
results of a spinal X-ray in a few minutes. Otherwise, a
radiologist usually has the official X-ray report
ready the next day.
The bones of the spine
(vertebrae) are normal in number, size, shape, appearance, and how they are
No broken bones,
dislocations, or foreign objects are present. The soft
tissues around the vertebrae look normal.
The spine is not abnormally
Broken bones, dislocations, or
foreign objects are present.
The spine is abnormally
curved, such as from
Diseases that affect the
spine, such as thin bones (osteoporosis) or
arthritis, are present. One or more bones in the
spine may be abnormal because of a condition you were born with or because of cancer, infection, or trauma.
Disc disease, which is fairly
common, can sometimes be seen on a spinal X-ray as a narrowed space between the
bones of the spine. Bone spurs can also be seen.
What Affects the Test
Reasons you may not be able to
have the test or why the results may not be helpful include:
If you are pregnant. The X-rays may not be safe
can't remain still during the test. The pictures may not be
If you are very overweight. This can make it hard to see the
details of the spinal X-ray.
What To Think About
Your X-ray results may be different from earlier test results
because you were tested at a different medical center or you had a different
kind of test.
common causes of low back pain, such as strained back muscles or ligaments, do
not show up on a spinal X-ray.
Other tests, such as a
CT scan, an
MRI, or a
myelogram, provide more information about the spinal
bones, joints, nerves, discs, muscles, and ligaments than a spinal X-ray.
Spinal X-rays have been used by
some employers to screen healthy people for possible future back problems. But
most doctors do not believe that this is appropriate. If a
potential employer wants you to have a spinal X-ray before you can start
working, you may want first to discuss the matter with the employer and your
Other Works Consulted
Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis:
Fischbach FT, Dunning MB III, eds. (2009).
Manual of Laboratory and Diagnostic Tests, 8th ed.
Philadelphia: Lippincott Williams and Wilkins.
How this information was developed to help you make better health decisions.