[CMCH]

#4656

Hi Doctor,

I’m an American expat living overseas, and I went into a local hospital for my lower back pain. The doctor at the hospital ordered a full-spine x-ray and a series of lumbar-spine x-rays. The full spine x-rays were made up of three images, and the lumbar series had four views – 1 from the front, 1 from the side, and 2 oblique views. I had them done all at once and without the benefit of a lead apron.

Nothing was diagnosed from the x-rays. But I’ve discovered only later that some of the x-rays, like the full-spine and oblique views of lumbar, might not have been necessary at all! I’ve also found out that the full-spine and lumbar x-rays expose you to a high level of radiation.

I wanted to get feedback from a real spine specialist whether the x-rays I was prescribed are routine, and perhaps more important, whether the radiation dose I was exposed to was high, especially given that they were all administered in one session, and whether I should worried about the consequences from the radiation exposure.

I’m very much concerned about the radiation, and I would very much appreciate any and all feedback and info you might be able to provide. Thank you, Doctor, in advance for your help.

[Donald Corenman, MD, DC]

#4657

Standard X-ray series for lower back pain varies from doctor to doctor. The very basic X-ray series is an AP and lateral lower back image. This will give basic data on disc, alignment and degenerative changes. If the series is performed in a standing position, so much the better as now there is evidence of gravity’s affects the spine.

I include a standing flexion and extension lateral x-ray for a 4 view series as instability can be determined by these additional X-rays and cannot by any other means.

The scoliogram X-rays (full spine front and back view) are normally reserved for patients with deformity by examination (scoliosis, increased kyphosis, old fractures). In the States, it is not common for those images to be included unless suspicion of deformity or imbalance is suspected.

I do not use oblique films much anymore as these are designed to look at the pars of the vertebra and rarely yield much new data.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[CMCH]

#4658

Thank you, Doctor, for your detailed and prompt response.

All the x-rays were done standing up. The machine used for the x-rays is GE Definium 8000. I think I had five exposures in total, one for full spine and four for lumbar spine.

I’m 38, and I’m really worried about the amount of radiation I was exposed to from the x-rays. Basically I’m worried that I exposed myself to increased chance of cancer down the road.

Should I be worried? I’m wondering if the amount of radiation exposure was too much for one session, having had both the full-spine and lumbar series, especially in a concentrated manner for my lower back/pelvis area.

Perhaps, I’m overreacting, but I had a CT done of my chest that was proven completely unnecessary a year and a half ago here in Korea. I’d love to know your opinion on this matter of having been administered both the full-spine and lumbar-spine x-rays at the same time. An informed and professional assessment from a great experienced doctor like you would go a long way in easing my mind.

Thank you again for your help and advice Doctor.

[CMCH]

#4659

Thank you, Doctor, for your detailed and prompt response.

All the x-rays were done standing up. The machine used for the x-rays is GE Definium 8000. I think I had five exposures in total, one for full spine and four for lumbar spine.

I’m 38, and I’m really worried about the amount of radiation I was exposed to from the x-rays. Basically I’m worried that I exposed myself to increased chance of cancer down the road.

Should I be worried? I’m wondering if the amount of radiation exposure was too much for one session, having had both the full-spine and lumbar series, especially in a concentrated manner for my lower back/pelvis area.

Perhaps, I’m overreacting, but I had a CT done of my chest that was proven completely unnecessary a year and a half ago here in Korea. I’d love to know your opinion on this matter of having been administered both the full-spine and lumbar-spine x-rays at the same time. An informed and professional assessment from a great experienced doctor like you would go a long way in easing my mind.

Thank you again for your help and advice Doctor.

[Donald Corenman, MD, DC]

#4660

We all need to be aware of x-ray exposure. Certainly, significant exposure can increase the chance of certain types of cancer. Your exposure for this lower back series by itself is probably no need for concern. Certain populations have a greater exposure by location or by occupation.

For example, I live at 8000 feet altitude which increases my exposure of naturally occurring radiation and airplane pilots have a significantly increased exposure by “living” at 35,000 feet for a percentage of their lives and incidence of cancer is not significantly higher.

Just be aware and ask if the test is really necessary.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[CMCH]

#4661

Thank you Doctor. Will do. Just was really worried about having received simultaneously both full-spine and lumbar series, which seem the kind that requires higher level radiation than the normal x-rays.

The fact that I can connect with you from another end of the world seems somehow wondrous to me. I thank you so much for your kind, informed, and best of all prompt responses to my questions. I’ll definitely spread the word about your kindness and professionalism. Thanks again so much for your help.

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