SPINE CHECKS AND SCANS

WHY DO YOU NEED A SPINE CHECK?
Dr Prem Pillay, Spine Expert and Specialist, Singapore

Spine problems can cause  Back pain and Neck Pain, but certain spine problems can lead to nerve damage with consequent Weakness, Increased Pain and Numbness including in the Body, Arms and Legs;  Bladder and Bowel loss of control, and even Paralysis. Damage or injury to Spine Nerves beyond a certain level results in chronic problems and we don’t have the technology yet to reliably replace and repair these Spine Nerves.

Many people treat their Back Pains and Neck Pains with Pain Medications and Patches, TCM, Chiro, Osteo, Yoga, Pilates, Physio and Massage therapy but don’t find out the root of their problems in the Spine. Not all problems are from muscle strains around the Spine. In general if your Back Pain and Neck Pain cannot be relieved by at least 2-3 sessions of therapy you should get your Spine checked by a real Medical Spine Specialist at a Spine Center. A proper Spine Check with Scans can allow an accurate Diagnosis of your Spine problem. Spine problems include Spine Disc injury and disease, Spine bone injury and disease, Spine joint injury and disease, Spine Tumors including Spine Cancer, Spine Infections, Spine Arthritis and Degeneration  including Spondylosis, Spine Stenosis, Spondylolysis, Spondylolisthesis, Disc Degeneration and Facet Arthropathy. This is not an exhaustive list.

Earlier Diagnosis can lead to better and less invasive Spine treatments and reduce the chance of Future serious problems as described above. A Healthy Spine allows better Mobility ,less Pain with a Better quality of Work Life , and Home and Recreational Life as well.

          

WHAT IS A SPINE CHECK?

Medical Spine Specialists are specially Qualified, Trained and Accredited (by the Ministry of Health, Recognized Medical Degrees accredted by the Medical Council, Recognized International Medical Specialist training and qualifications which are Singapore-Academy of Medicine,USA,Canada, UK recognized for instance). This is not the same as those who have trained as non medical Doctors and are not recognized by the Ministry of Health.

In the Spine Check, the Real Spine Specialist will collect a detailed story of your complaints current and past, any other illness, medication, allergies (History), and then carry out a Clinical Physical Spine and Nerve Examination. The Spine Nerves are the most important part of your Spine and a proper Nerve examination is an essential part of the examination. In the examination, the spine mobility is ascertained, tender spine points, tense muscle areas,  motor strength, sensation disturbances, Reflexes, and Gait are all checked.

Based on all these, the Spine Specialist will arrive at a possible cause (called a Clinical Diagnosis) and can suggest the tests needed.

SPINE SCANS AND TESTS

• X rays of the Spine: the new digital scans have excellent resolution to give good images (pictures) of the Spine bones and their alignment . There are three different sections of the spine that can be X rayed: Cervical (the top or center of the Neck) Spine, Thoracic (middle) Spine, and Lumbar-Sacral Spine (Lower).
• MRI (Magnetic Resonance Imaging of the Spine. This gives the clearest image (picture) of the Spine of all the scans especially of the soft parts of the spine such as the Discs and the Nerves. There is no radiation used and only Magnetic waves.  It is also good for detecting Spine Tumors and Cancer.
• CT (Computed Tomography) of the Spine. This is now a less common test as the images are not as good for the soft parts of the spine and radiation energy is used ( albeit quite low). It is used for fine bone details such as in the vertebral bodies and facet joints and for calcification assessment such as in Ossification of the Spine Ligaments or for Fusion success after surgery.
• EMG/NCS (ElectroMyogram/Nerve Conduction Studies) are used to detect electrical signals from Muscles and Nerves to determine the level of a spine nerve impingement (pinching point or pressure point) or to find out if there is a problem that is either in the spinal cord or further away in the peripheral nerves which come out of the spine and travel down the arms or legs.
• Bone Mineral Density: Also called Dual Energy X-ray Absorptiometry (DEXA) is used to measure the amount of Calcium Minerals in your Bones. This will allow a diagnosis of normal, osteopenia (low bone density) or osteoporosis (very low bone density with high risk of fractures) to be determined so that preventive and protective treatment can be started early.
• Blood Tests: a variety of blood tests may be ordered depending on the clinical and radiological diagnosis. This may include inflammation markers such as ESR, CRP; white cell counts for infection, Calcium, phosphate,VIt D levels (for bone health), Vit B12 and Folate levels (related to Nerve health) and several others.

With many years of experience in treating Spine problems and access to the latest technological advancements, Dr Prem Pillay endevours to offer patients the highest standard of care. From accurate diagnosis to tailored treatment plans, our approach aims for the best possible outcomes for individuals affected by this challenging condition.

If you or a loved one has been suffering from Back Pain or Neck Pain which could be a spine problem, we welcome you to seek consultation with our experienced Spine Specialist. Together, we can quickly do the Spine Checks and Scans needed for an accurate diagnosis. We can then develop a comprehensive evidence based and personalized treatment strategy based on the latest science based Medical advances that address your unique needs and provides the best chance for a positive outcome.