Mr James Langdon

BSc (Hons) MB BS MRCS (Eng) FRCS (Orth) Consultant Orthopaedic Spinal Surgeon

Spinal Investigations

In order for your back to be properly assessed you may be asked to undertake a variety of diagnostic tests. The most common tests used to diagnose back problems are X-rays and MRI scans.


An X-ray is a painless process that uses a low dose of radiation to take a picture of your spine. X-rays show bones, but not much soft tissue. Despite high quality scans, x-rays remain useful as they provide valuable information that is not readily available from MRI or CT scans, particularly when assessing spinal deformities and abnormal movement. These x-rays are often taken with the patient standing.


Magnetic Resonance Imaging (MRI) has revolutionized our understanding and treatment of the spine. MRI uses a powerful magnetic field and radio waves to create computer-generated images that allow us to see the spine in fine detail, enabling us to identify abnormalities of the soft tissues, such as the discs and the nerves. It can also be useful for evaluating certain bony pathologies.

MRI is painless and does not involve any radiation. The only problem is the need to lie still inside, or at least partially inside, the large, cylindrical magnet where it can be a bit claustrophobic and noisy. An MRI scan normally takes about 30 minutes. It can be longer if more than one part of your spine needs to be scanned.

CT scans

Since the advent of MRI, CT scans have been used less in the evaluation of spinal problems. As with x-rays, CT is a process that uses radiation to take a picture of your spine. The dose of radiation though is much higher than with x-rays. CT is still used to assess 3D spinal anatomy (particularly when patients have a spinal deformity or other unusual anatomy) and to evaluate certain bony pathologies.

Some patients are unable to go into a MRI scanner as they have something in their body that would be at risk if exposed to a large magnet, such as a pacemaker, cerebral aneurysm clips, or a small piece of metal lodged in the eye. In these patients CT is sometimes used as an alternative to MRI.