A computed tomography (CT) scan of the lumbar spine makes cross-sectional pictures of the lower back (lumbar spine). It uses x-rays to create the images.
You will be asked to lie on a narrow table that slides into the center of the CT scanner.
Once you are inside the scanner, the machine's x-ray beam rotates around you. (Modern "spiral" scanners can perform the exam without stopping.)
A computer creates separate images of the spine area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the spine area can be created by adding the slices together.
You must be still during the exam. Movement can cause blurred images. You may be told to hold your breath for short periods of time.
The scan should take only 10 to 15 minutes.
Some exams use a special dye, called contrast that is put into your body before the test starts. Contrast helps certain areas show up better on the x-rays.
Contrast can be given in different ways.
If contrast is used, you may also be asked not to eat or drink anything for 4 to 6 hours before the test.
Let your health care provider know if you have ever had a reaction to contrast. You may need to take medicines before the test in order to avoid this problem.
If you weigh more than 300 pounds (135 kilograms), find out if the CT machine has a weight limit. Too much weight can cause damage to the scanner's working parts.
You will be asked to remove jewelry and wear a hospital gown during the study.
Some people may have discomfort from lying on the hard table.
Contrast given through an IV may cause a slight burning feeling, a metal taste in the mouth, and a warm flushing of the body. These feelings are normal and go away in a few seconds.
CT scans rapidly makes detailed pictures of the lower back. The test may be used to look for:
This test can also be used during or after an x-ray of the spinal cord and spinal nerve roots (myelography) or an x-ray of the disk (discography).
Results are considered normal if no problems are seen in the lumbar region in the images.
Abnormal results may be due to:
Risks for CT scans include:
CT scans expose you to more radiation than regular x-rays. Having many x-rays or CT scans over time may increase your risk for cancer. However, the risk from any one scan is small. Talk to your provider about this risk and how it weighs against the benefits of the test for your medical problem.
Some people have allergies to contrast dye. Let your provider know if you have ever had an allergic reaction to injected contrast dye.
Rarely, the dye may cause a life-threatening allergic response called anaphylaxis. If you have any trouble breathing during the test, you should tell the scanner operator right away. Scanners come with an intercom and speakers, so the operator can hear you at all times.
The lumbar CT scan is good for evaluating large herniated disks, but it can miss smaller ones. This test can be combined with a myelogram to get a better image of the nerve roots and pick up smaller injuries.
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.