Spinal X-Ray

Medically Reviewed by Poonam Sachdev on March 02, 2023
Written by Teresa Dumain
4 min read

A spinal X-ray is a procedure that uses radiation to make detailed pictures of the bones of your spine. It can help your doctor find out what's causing your back or neck pain.

A technician uses a machine that sends X-ray beams through your body. It records a black-and-white image on a special film or computer. Bones, and other parts of your body that are thick or dense, show up white in the picture. Softer tissue, like fat or muscle, appears in shades of gray.

Your doctor can take separate X-rays that focus on the different parts of the spine, which is made up of 33 small bones called vertebrae.

Your spine is split into sections:

  • Cervical spine (seven vertebrae in the neck)
  • Thoracic spine (12 vertebrae in the chest or trunk area)
  • Lumbar spine (five vertebrae in the lower back)
  • Sacral area (five small, fused vertebrae in the base of the spine)
  • Coccyx (four coccygeal vertebrae fuse to form one bone called the coccyx or tailbone)

A spinal X-ray can help your doctor figure out if you have:

  • Broken bones
  • Arthritis
  • Spinal disk problems
  • Tumors
  • Osteoporosis (thinning of the bones)
  • Abnormal curves of the spine
  • An infection
  • Spinal problems you were born with

X-rays are useful in pinpointing broken bones or skeletal defects. They can sometimes locate problems in connective tissue. 

X-rays and imaging studies are generally used to confirm your symptoms and exam results to identify the source of pain. Scans are also used in cases of direct trauma to the back, back pain with fever, or weakness or numbness in the limbs.

While X-rays don't show as much detail as other imaging tests, they are often the tests doctors use at first to help them decide on your next steps.

Computed tomography (a CT scan) combines X-rays with computer technology to create a picture that shows a cross-section, or slice, of the bone.

For the most detailed pictures of the spine and all its parts, doctors often suggest magnetic resonance imaging (MRI). It uses powerful magnets, radio waves, and a computer – not radiation.

For most people, X-rays are safe. Some worry that the radiation can cause changes in cells that may lead to cancer. But the amount used in spinal X-rays is small, so the chance is low. You may want to keep track of previous X-rays to let your doctor know about it. There may be some risks from the number of X-rays over a long period of time. If you have concerns about it, talk to your doctor. 

But unborn babies are more sensitive to radiation. Tell your doctor if you're pregnant or think you might be. They may suggest another type of imaging test.

Before your spinal X-ray, besides telling your doctor that you are or might be pregnant, let them know if you have an insulin pump or if you’ve had any other types of X-rays, like a barium X-ray, in recent months.

You may need to remove your clothes and wear a gown during the test. Also, anything that's made of metal may show up on an X-ray, so remove things like these beforehand:

You'll lie down on a special exam table. An X-ray machine will be hanging above you. A drawer under the table holds the X-ray film or digital recording plate.

A specially trained technician will position you on the table so that the section of your spine getting X-rayed is between the machine and the drawer with the film. They may cover the other parts of your body with a special apron made of lead that blocks radiation.

The technician will step behind a window barrier and turn on the X-ray machine. You'll need to stay still and hold your breath while the beams pass through your body. This only takes a few seconds. If you move, it may blur the image.

You may hear some clicking or buzzing noises while you get your X-ray, but you won't feel anything. An X-ray is painless.

In some cases, you may need to stand next to the X-ray machine. Your doctor may also ask that you get images from the front and the side of your spine, or while you stretch or bend.

An X-ray takes about 5 minutes to complete. But you may be in the room for longer, depending on how many images and views your doctor needs.

When your X-ray session is done, the technician will process the images. They may ask you to wait a few minutes to make sure the pictures are clear.

Your doctor, or sometimes a specialist called a radiologist, will look over your spinal X-rays. You'll discuss the results with your doctor, who will explain what it all means and what comes next.