What are X-rays of the spine, neck, or back?

X-rays use energy beams to make pictures of tissues, bones, and organs on film or a computer. Standard X-rays are done for many reasons. These include diagnosing tumors, bone injuries, and other reasons for spine pain.

X-rays pass through body tissues onto special plates similar to camera film. This makes a "negative" type picture. The more solid a structure is, the whiter it looks on film. Instead of film, X-rays are now often made by using computers and digital media.

When X-rays pass through the body, different parts of the body allow different amounts of the X-ray beams to pass through. Images show up with some parts light and other parts dark. How light or dark the areas are depends on the amount of X-rays that pass through the tissues. The soft tissues in the body, such as blood, skin, fat, and muscle, let most of the X-ray pass through. These areas look dark gray on the film. A bone or a tumor is denser than soft tissue. It does not let many X-rays to pass through and looks white on the X-ray. At a break (fracture) in a bone, the X-ray beam passes through the broken area. It's seen as a dark line in the white bone.

X-rays of the spine may be done to look at areas of the spine. These are the cervical, thoracic, lumbar, sacral, and coccygeal sections. Other imaging tests may also be used to diagnose spine, back, or neck problems. These are myelography (myelogram), CT scan, MRI, and bone scans. 

Why might I need X-rays of the spine, neck, or back?

X-rays of the spine, neck, or back may be done to diagnose:

• The cause of back or neck pain

• Broken bones (fractures)

• Arthritis

• Dislocation or slipping of one vertebrae over the one below it (spondylolisthesis)

• Degeneration of the disks

• Tumors

• Problems in the curvature of the spine, such as kyphosis or scoliosis

• Problems you are born with (congenital)

Your healthcare provider may have other reasons to advise an X-ray of the spine, neck, or back.

What are the risks of X-rays of the spine, neck, or back?

You may want to ask your healthcare provider about the amount of radiation used during the procedure and the risks related to your particular case. It’s a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays. This lets you tell your healthcare provider what you had done before. Risks linked to radiation exposure may be related to the total number of X-ray exams or treatments over a long period of time.

Tell your healthcare provider if you are pregnant or think that you may be pregnant. Radiation exposure during pregnancy may cause birth defects. If you need a spinal X-ray, the healthcare team will take special safety measures to limit the radiation exposure to your unborn baby.

You may have other risks depending on your specific health condition. Discuss any concerns with your healthcare provider before the procedure.

How do I get ready for X-rays of the spine, neck, or back?

• Your healthcare provider will explain the procedure to you and give you the chance to ask any questions that you might have.

• You don’t usually need to prepare for the X-ray. You don’t need to fast or get medicine (sedation) to help you relax.

• Tell the radiologic technologist if you are pregnant or think you may be pregnant.

• Tell the radiologic technologist if you have had a recent barium X-ray procedure. This may interfere with getting a good X-ray image of the lower back area.

• Based on your health condition, your healthcare provider may ask you to do other specific things to get ready.

What happens during X-rays of the spine, neck, or back?

You may have an X-ray as an outpatient. This means you go home the same day.  Or you may have the X-ray as part of your stay in a hospital. Procedures may vary depending on your condition and your healthcare provider's practices.

Generally, an X-ray procedure of the spine, neck, or back follows this process:

1. You will be asked to remove any clothing, jewelry, hairpins, eyeglasses, hearing aids, or other metal objects that may get in the way of the procedure.

2. If you are asked to remove any clothing, you will be given a gown to wear.

3. You will be placed on an X-ray table so that the part of the spine that is to be X-rayed is between the X-ray machine and a cassette containing the X-ray film or digital media. Your healthcare provider may also request X-ray views to be taken while you are standing.

4. Body parts not being imaged may be covered with a lead apron (shield) so they aren’t exposed to the X-rays.

5. The technologist will ask you to hold still in a certain position for a few moments while the X-ray exposure is made.

6. If the X-ray is being done to find an injury, special care will be taken to prevent more injury. For example, a neck brace may be put on your neck if the provider thinks you have a neck fracture.

7. Some spinal X-ray studies may need several different positions. Unless the technologist tells you otherwise, it's very important to stay completely still while the exposure is made. Any movement may distort the image. You may even need another study done to get a clear image of the body part in question. You may be asked to breathe in and out during a thoracic spine X-ray.

8. The X-ray beam will be focused on the area to be photographed.

9. The technologist will step behind a protective window while the image is taken.

The X-ray procedure itself causes no pain. But moving the body part being checked may cause some discomfort or pain. This is especially true for an injury or during surgery. The technologist will use all possible comfort measures. They will complete the procedure as quickly as possible to reduce any discomfort or pain.

What happens after X-rays of the spine, neck, or back?

You usually don’t need any special type of care after an X-ray of the spine, back, or neck.  But your healthcare provider may give you additional or different directions after the procedure, depending on your particular case.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.