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Quantitative CT scans are primarily used to evaluate bone mineral density at the lumbar spine and hip. In general, solid phantoms placed in a pad under the patient during CT image acquisition are used for calibration. These phantoms contain materials that represent a number of different equivalent bone mineral densities.
A CT scan is typically performed after radiographic contrast media (dye) has been placed with fluoroscopic guidance into a sac-like lining (the first- and hardest and outermost- layer of the spinal meninges, the spinal dura mater) surrounding the spinal cord and nerves. The material is typically water-soluble, which has largely replaced ...
Even though the CT scan allows for intensive image studying, the fixed nature of the image collection process alone is not enough to reach a definitive diagnosis of lumbar spinal stenosis. The outcome of the CT scan can help compile physiological evidence that the patient has lumbar spinal stenosis, and that the patient may potentially benefit ...
The radiation doses received from CT scans is variable. Compared to the lowest dose X-ray techniques, CT scans can have 100 to 1,000 times higher dose than conventional X-rays. [149] However, a lumbar spine X-ray has a similar dose as a head CT. [150]
In CT myelography, spinal tap is performed in the low back with dye injected into the spinal fluid. X-rays are performed followed by a CT scan of the spine to help see narrowing of the spinal canal. This is a very effective study in cases of lateral recess stenosis.
Bone scans are conducted to rule out possible fractures and infections, magnetic resonance imaging (MRI) is used to eliminate the possibility of the spinal cord or nerve abnormalities, and computed tomography scans (CT scans) are used to get a more detailed image of the bones, muscles, and organs of the lumbar region. [19]
Enostosis is usually found in T1 to T7 for the thoracic spine and L2 to L3 in the lumbar spine. It consists of cortical bone merging with medullary bone with irregular margins. The shape of the lesion is round or oval with a thornlike margin, up to 2 cm in diameter. In both T1 and T2-weighted imaging, it shows low signal intensity.
CT scan image of large herniated disc in the lumbar spine. Removal of a disc at one level can lead to disc herniation at a different level at a later time. Even the most complete surgical excision of the disc still leaves 30–40% of the disc, which cannot be safely removed. This retained disc can re-herniate sometime after surgery.
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