When should an X-ray be performed for a herniated disc?

The article is professionally consulted by Master, Doctor Luu Thi Bich Ngoc - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International Hospital

Herniated disc is a fairly common disease, although not life-threatening, but causes significant effects on quality of life. X-ray in the case of disc herniation, although unable to make a definite diagnosis, but on X-ray there are some signs suggestive of disc herniation.

The disc is a structure consisting of 3 main components, which is a mucous nucleus on the inside, around the fibrous ring with fairly strong fibers arranged in a central ring and a cartilaginous plate where it comes into contact with the vertebral body. The disc located between the 2 vertebrae works to help the body move more flexibly and also reduce shocks and shocks when the body moves and withstands more pressure.
Herniated disc occurs when the mucous nucleus of the disc is out of place, causing compression on the nerves with symptoms depending on the degree of compression. It can be bilateral or more severe, central hernia.
Herniated disc disease is common among osteoarthritis, although not directly threatening the patient's life, it seriously affects mobility, health and reduces working capacity since then. little impact on quality of life.

The most common location of herniated disc is the cervical spine and lumbar spine because it is at this position that the spine bears the greatest load from the body. When there is a herniated disc, leading to nerve compression, it can cause symptoms such as:
Spine syndrome: Deviated, reduced physiological curve, causing pain and restricting part of the spine's activities , the paravertebral muscle organization is stiff and painful. Nerve root syndrome: When there is nerve compression, depending on the degree, symptoms such as pain along the path of the nerve, pain accompanied by sensory disturbances such as numbness, burning .. In addition, severe cases can cause loss of limb activity, muscle atrophy, and urinary dysfunction. For the cervical spine, causing pain spreading to the hands and fingers, which may be accompanied by numbness or burning; for the lumbar spine, causing back pain spreading to the buttocks, legs, toes and possibly accompanying sensory disturbances. X-ray for herniated disc in the following cases:
Seeing signs of pain, soreness, limited movement of the spine and numbness, prolonged or increased burning of limbs, which directly affects daily life . Seeing muscle atrophy, difficulty in movement, weakness and paralysis of limbs. Have a bowel or bladder dysfunction such as fecal incontinence, urinary retention or urinary incontinence. Decreased or loss of sensation in the inner thighs, back of the legs, and anus. Usually, on X-ray, the disc organization cannot be seen because the disc is not contrasted. We can only see the change of the disc indirectly causing changes on the X-ray film.
Some signs can be seen on the X-ray film that can help guide the diagnosis of hernia such as:
On the tilt film, there is a decrease in the physiological curve of the spine or there are abnormal shapes, the vertebrae may slide from the original position. On straight film, scoliosis is seen, and the height of the intervertebral space is reduced. In addition, X-ray has the advantage of being able to detect fractures or collapse of the vertebrae after an injury,... If the X-ray film has suggestive signs associated with clinical manifestations. When ready, the doctor will order some more specialized tests such as MRI to diagnose the disease and assess the extent of the damage.

Some notes when taking X-rays:
Should provide enough information to the doctor, especially if the patient is pregnant, especially in the first 3 months. Do not take X-rays of herniated discs for pregnant women because it can affect the development of the fetus and the risk of birth defects. Before taking the picture, the patient does not need to prepare much, just remove the objects that affect the image quality such as hairpins, necklaces, belts, eyeglasses, ... to avoid affecting the results of the scan. . X-ray in case of suspected herniated disc is a simple, inexpensive method and can provide some suggestive images to help identify the disease. Therefore, as soon as you see abnormal symptoms in the spine such as pain, limited mobility or pain spreading to the arms or legs, you should go to a medical facility for early examination.
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