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Picture this: Understanding spinal imaging
Episode 1622nd June 2020 • Back Talk Doc • Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates
00:00:00 00:25:48

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One of the most common responses to feeling back pain is asking your physician for an x-ray to determine what’s causing it. However, the process of coming to diagnosis to properly treat any pain goes more than just reading off of an x-ray or MRI test result.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia gives a rundown on how physicians determine the proper dedicated imaging option needed for a patient. Numerous factors affect decision-making as each scenario is different. First, the doctor takes a look at the medical history and identifies any red flags such as a history of cancer, unexplained weight loss, and other neurological symptoms.

For many cases, if there are no alarming red flags, then conservative care is suggested first before undergoing any type of imaging test. When the pain isn’t managed after, then the physician may require either an x-ray, MRI, or CAT or bone scans. Dr. Sanjiv also discusses the best and most effective imaging option for certain spine conditions, including herniated discs, spinal infections, osteoporosis, cancer, and other rare conditions. 

At the end of the day, if your physician does not suggest any type of imaging, then you may have a low risk for any serious condition. Conservative care is always recommended to spare you any unnecessary testing and radiation. The majority of low back pain, in particular, is going to be self-limiting and with the proper management will resolve after some time.

Key Moments in the Episode

Red flags that affect the physician's decision-making process 03:19

Low back strain 08:10

Radiculopathy 09:30

Herniated disc 10:43

Considerations bout gadolinium 12:45

Lumbar spinal stenosis 13:13

Cauda Equina Syndrome 15:27

Spinal infection 16:24

Malignancy or cancer 17:44

Osteoporosis 20:43

Disc herniations 22:14

Links Mentioned in the Episode

The Use of Imaging in the Management of Patients With Low Back Pain by Dinesh Rao

Worth a Shot? Spinal Injections with Dr. Andrew Sumich

Cutting Edge Surgery with Dr. Mark Smith

The Narrowed Path, Understanding Spinal Stenosis with Joe Cheatle MD

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at