Dr Adriaan Liebenberg My Spine Lumbar | Page 57

My Spine - Lumbar What is a discogram? In this test, contrast (dye) is injected with the help of fluoroscopy (mobile X- ray machine) directly into the intervertebral disc. The test has two elements. The first element is when your specialist attempts to mimic your pain by injecting fluid into your disc and therefore tries to place stress on the disc. This is a diagnostic test that can be very difficult to interpret. The other ele- ment is looking at the image on the fluoroscopy to see what the fibres of the disc look like and to see whether there is any damage. What is a radio isotope scan? In this test, radio isotopes are injected into a vein and allowed to circulate. A scan is then performed, which picks up radio isotope uptake. The radio iso- topes are taken up in bony areas of the body where there is inflammation and will help your specialist decide where the main inflammation is located that causes your pain. Terminology in the lumbar region for CT scans and MRI scans Spinal stenosis – This means that the spinal canal is narrowed. This is usual- ly because the joints that are between the vertebrae, called the facet joints, have hypertrophied (become larger) secondarily to osteoarthrosis of these joints. At the same time the ligament that runs inside the spinal canal, the lig- amentum flavum, has also hypertrophied and is pushing on the nerves. The third component that causes spinal stenosis is the pressure from discs that push into the spinal canal. Facet joint hypertrophy – This is when the joints between the vertebrae become large and irregular. This is because the joints are damaged by arthri- tis (osteoarthritis). 57