Figure 1: Compression fracture
(arrow) resulting in collapsed,
wedge-shaped vertebra (X-ray).
X-rays are often the first diagnostic test for back and neck pain, because they are very good at visualizing the bones of the spine. X-rays, also known as .radiographsê or .plain filmsê, see the calcium of bones, making visible any misalignments in the spine as well as making it possible to see if disease has involved the vertebral bodies, pedicles, and facet joints.The intervertebral discs are only seen as empty spaces between the vertebrae. Herniated discs cannot be diagnosed by x-ray, but degeneration and loss of disc space height can be seen. [Figure 1] Different x-ray views may be needed in order to fully visualize all bony elements suspected of injury or disease. X-rays done with the spine in different positions, such as flexing and extending or standing and lying flat, are commonly performed to evaluate for possible spinal instability.
X-ray images are made by ionizing radiation (electromagnetic rays) passing through the body to a sensitized sheet of film, with tissues absorbing either more or less of the X-rays. The concept is not unlike that of a camera where, through a lens, film is exposed to light and an image immediately forms on the film, which must be developed before it is viewed. All X-rays exams expose the body to a very low amount of radiation.