Name of the Procedure:

Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections.
Common name(s): CT scan of the lumbar spine with and without contrast.

Summary

A CT scan of the lumbar spine uses X-ray technology to create detailed images of the lower back's bones and soft tissues. Initially, images are taken without contrast dye, then a contrast material is injected to provide more clarity and highlight specific areas of interest.

Purpose

The procedure helps identify abnormalities in the lumbar spine such as herniated discs, fractures, infections, tumors, and spinal stenosis. The goal is to provide a comprehensive view of the spine to aid in diagnosis and treatment planning.

Indications

• Persistent or severe lower back pain
• Suspected herniated discs
• Symptoms of spinal stenosis (numbness, weakness)
• Previous spinal surgery evaluation
• Suspected tumors or infections in the spine

Preparation

• Fasting may be required for a few hours prior to the procedure.
• Patients should inform their doctor about any medications they are taking and any allergies, especially to contrast dyes.
• A preliminary blood test might be needed to check kidney function, ensuring it is safe to administer the contrast material.

Procedure Description

1. The patient lies on a motorized table that slides into the CT scanner.
2. Initial images are taken without contrast.
3. Contrast material is injected intravenously, which may cause a warm sensation.
4. Further images are captured to highlight specific structures.
5. The patient needs to remain still during the scan to ensure clear images.

Tools: CT scanner, IV line for contrast dye injection.
No anesthesia is required, but mild sedation may be offered if the patient is anxious.

Duration

The entire procedure typically takes about 30 minutes to an hour.

Setting

Performed in a radiology department within a hospital or an outpatient imaging center.

Personnel

• Radiologist
• Radiologic technologist
• Nurse (for administering contrast material if needed)

Risks and Complications

• Common: Mild allergic reactions to the contrast material.
• Rare: Severe allergic reaction, renal function impairment, radiation exposure risks. Any complications are managed promptly by medical staff present.

Benefits

• Provides detailed images aiding accurate diagnosis.
• Can guide treatment decisions and plans.
• Results are usually available within 24-48 hours.

Recovery

• Patients might be observed for a short period after the procedure.
• Drink plenty of fluids to help flush the contrast material from the body.
• No significant recovery time; normal activities can typically be resumed immediately.

Alternatives

• MRI of the lumbar spine: More detailed images of soft tissues but may not be suitable for patients with metal implants.
• X-rays: Less detailed than CT but quicker and less expensive.
• Physical therapy or conservative management before imaging diagnostics.

Patient Experience

• The patient may feel a warm sensation when the contrast dye is injected.
• Some discomfort from lying still.
• Pain management options are available if necessary.
• Most patients find the procedure tolerable and experience no significant discomfort afterward.