How is spinal instability diagnosed?

Displaced vertebra

The patient will first be examined by a neurologist. Depending on what s/he is told by the patient, the neurologist may also perform a medical imaging procedure, which will often enable him or her to make a diagnosis.

spinal instability

Diagnosis of spinal instability

Degenerative Disc Disease

Medical imaging procedure

Here, too, the patient will first see a neurologist, after which they will often undergo one or more medical imaging procedures – generally, an X-ray photo and an MRI scan. A radiologist will then often describe one or more intervertebral discs that show up black in the images and must therefore be dehydrated (so-called ‘black discs’).

Degenerative disc disease (DDD)

Sometimes an image will show a ‘modic sign’, i.e., an inflammation of the degenerated intervertebral disc in the adjacent vertebrae. Quite often the height of the intervertebral disc will have decreased, thus reducing the disc’s ability to do what it is supposed to do, i.e., absorb shock and keep the adjacent vertebrae mobile.

Plaster corset

If the patient’s symptoms are reduced when s/he is not using his or her back much, a plaster corset may be used to predict the results of an operation whereby a part of the spine is temporarily immobilised from the outside. Such a test corset covers the upper legs and is generally worn for two weeks. While wearing the corset, the patient will be able to walk, lie down and go to the toilet as usual. However, s/he will be unable to bend over and sit down.

Discogram

A discogram may help the doctor make a correct diagnosis. If the patient’s doctor suspects an intervertebral disc is the source of the patient’s pain, he may request that some contrast agent be injected into the disc to determine whether or not the pain becomes more intense. He will subsequently request that a numbing agent be injected into the disc. If the pain then subsides, this may be a sign that the intervertebral disc is involved in the patient’s problems.

This test will be performed by an anaesthetist at Bergman Clinics'. Back and Neck Centre. You will see him or her for an intake interview before being subjected to the test in a separate appointment. The test will take half a day of your time, and you will have to be dropped off and picked up from the clinic by someone else. Since this test involves a temporary anaesthetic, if your deep backache returns, you will first have a telephone appointment with the anaesthetist to discuss the results of the test.

Psychological evaluation

The standard protocol may include a psychological evaluation, which is designed to provide our doctors with an insight into how the patient is dealing with his or her symptoms, what he or she expects from an operation, and what type of rehabilitation procedure might suit him or her best. None of these predictive evaluations will be 100% accurate. Once all tests have been completed, the patient may schedule a follow-up appointment with the neurosurgeon to discuss the results. Depending on the test results, the surgeon may propose that the patient undergo surgery

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