Spine X-Ray

What is a spine X-ray?

A spine X-ray is an imaging test that uses electromagnetic waves to take pictures of the bones in your neck and back. On an X-ray, your bones (in this case, your vertebrae) show up as white and your soft tissues (like muscle and fat) show up as shades of gray. Spinal X-rays help healthcare providers figure out why you have neck pain or back pain.

What is a spine X-ray called?

Spine X-rays have different names depending on which part of your spine needs imaging.

Your spine consists of sections, which include your:

• Cervical spine: These seven vertebrae make up your neck.
• Thoracic spine: This section of your spine consists of 12 vertebrae located in your upper and mid-back.
• Lumbar spine: These five vertebrae make up your lower back.
• Sacral spine (sacrum): Your sacrum consists of five small, fused vertebrae, located just above your tailbone.
• Coccyx (tailbone): You have four vertebrae at the base of your spine, but they all fuse together to form your tailbone.

So, the name of your X-ray depends on where you’re having issues. For example:

• An X-ray of your neck is a cervical spine X-ray.
• An X-ray of your thoracic spine shows your upper and middle back.
• An X-ray of your lower back is a lumbosacral spine X-ray.
• An X-ray of your tailbone is a coccyx X-ray.

What can a spine X-ray show?

A spine X-ray can give your healthcare provider information about a range of neck and back conditions, including:

• Fractured spine (broken back).
• Osteoporosis (weak bones).
• Arthritis (joint pain and inflammation).
• Spinal tumors (abnormal growth of cells in your spine).
• Slipped disk (when one of the cushions between your vertebrae moves out of place).
• Spinal curvature disorders, including lordosis (“swayback”), kyphosis (“hunchback”) and scoliosis (when your spine has a side-to-side curve).
• Congenital spinal issues, including neural tube defects (NTDs) like spina bifida. Congenital issues are conditions you’re born with.

How does a spine X-ray work?

During a spine X-ray, a radiologist uses an X-ray tube to pass a small amount of radiation through your body and onto an X-ray detector. (Photographic film is one type of X-ray detector. But there are also other types, like specially coated plates.)

Soft tissues like your skin, organs and muscles can’t absorb the X-ray energy passing through your body. But your bones absorb it. As a result, your soft tissues appear gray on the X-ray and your bones appear white.

How can I prepare for my spinal X-ray?

Typically, you don’t need to do anything to prepare for a spine X-ray. You can eat and drink normally prior to your appointment. Your provider will let you know if you need to do anything specific.

It might help to wear comfortable clothing and leave jewelry at home. Usually, you’ll need to remove any metal jewelry or clothing anyway so it doesn’t interfere with your X-ray images.

Do you stand up for a spinal X-ray?

It depends. For most spine X-rays, you’ll lie down on an exam table, usually on your back. This means the X-ray tube will be over your body while the X-ray detector is underneath you.

But in some cases, you might need to stand up for a spine X-ray. In these instances, the X-ray tube will be in front of you while the X-ray detector is behind you.

What to expect during a spine X-ray

The day of your spine X-ray, your radiologist will:

• Ask you to remove any clothing or objects that contain metal. (If you need to take off any clothing, they’ll give you a gown to change into.)
• Position you for your X-rays. (This might mean laying down or standing up.)
• Place a lead apron over areas of your body that don’t need X-rays (to protect you from unnecessary radiation).
• Step behind a protective window.
• Give you instructions while they take the X-rays. (This could include raising your arms or holding your breath for a few seconds.)

Spine X-rays usually take about 15 minutes to complete. Depending on how many pictures your provider needs, it might take a little longer.

Are spine X-rays painful?

X-rays don’t cause pain. But if your back is sore or tender in certain areas, you might feel some discomfort when your radiologist positions you. They’ll talk you through it and keep you as comfortable as possible during the test.

What are the risks of a spine X-ray?

X-rays are generally safe for most people. Repeated exposure to high-energy radiation can cause DNA damage over time. But when it comes to occasional X-rays for medical diagnosis, the images aren’t strong enough to cause this type of damage.

Your provider will give you a protective lead apron to wear during your test. This helps eliminate any excess radiation.

To reduce excessive exposure to radiation:

• Talk to your healthcare provider about your concerns.
• Keep track of how many X-rays you’ve had in the past and share records with all of your healthcare providers.
• If you’re pregnant, talk to your provider about postponing your X-rays. (While it’s usually OK to have X-rays when you’re pregnant, it’s best to wait when possible.)

When should I know the results of my spinal X-ray?

Your radiologist will prepare the images and send them to your primary care physician. Once your physician reviews your X-rays, they’ll discuss the results with you. This usually takes a day or two. Your healthcare provider will tell you what they see on your X-rays, explain what it all means and tell you what comes next.

If your provider needs additional information, they may recommend a myelogram. During this procedure, a radiologist injects a contrast dye into your spinal canal before taking X-rays and a CT (computed tomography) scan. The contrast material highlights areas of concern and helps your provider give you an accurate diagnosis.

A note from Cleveland Clinic

Neck and back pain can seriously hinder your comfort and quality of life. Spine X-rays are important for finding out why you have pain. They can show your provider things they can’t see during a physical exam, like fractures, slipped disks or curvatures. Getting a spinal X-ray helps your provider find the cause of your pain so they can recommend appropriate treatment.