Preoperative examination: scoliosis

To get a view of your scoliosis and your overall health, some tests are needed. The doctor will discuss with you which tests are required in your case.

EOS imaging

During an EOS imaging, X-rays are used to simultaneously image the spine and pelvis in the anterior/posterior and lateral directions. This is done to understand the influence of any arthrosis of the intervertebral disc that is present and any spinal canal stenosis on the position of the vertebrae among themselves in the standing position. The balance between the spine and pelvis is also examined.

Process:

  • You take your position in the EOS device.
  • You stand straight in a relaxed and natural manner while placing the fingertips on the collarbone.
  • In the meanwhile, X-ray images are taken.
  • While the images are being taken, you need to stand quietly and hold your breath for a moment.
  • The total examination takes only 30 seconds.

CT scan / SPECT-CT scan

A CT scan uses X-rays and provides detailed cross sections of the spine. The cross sections are converted by the computer into images from different angles and into 3D images. When this is combined with a nuclear scan, it is called a SPECT-CT scan.

Both CT and SPECT-CT scans provide information about the bone.

Process:

  • Before the examination, a contrast medium may be injected through a vein in your arm.
  • You will then take place on the examination table, usually on your back.
  • The table is scrolled through a wide dome. Meanwhile, X-ray images are taken. While the images are being taken, you are required to lie quietly and hold your breath for a moment.
  • The total examination takes an hour and a half where the CT scan itself takes about fifteen minutes.

You do not need to be fasting for this examination. Remember to inform the nurse about asthma or allergy, reactions to contrast agents in previous examinations, and (suspicion of) pregnancy.

MRI scan (Magnetic Resonance Imaging)

MRI scan provides information about the spinal cord, nerves, and muscles. MRI scan also makes cross sections of the spine. It uses short radio waves that generate signals in the body. Those signals are finally processed into images.

Process:

  • You will lay down on the examination table.
  • Before the examination, a contrast medium may be injected through a vein in your arm.
  • The table slowly slides into a large tunnel. It is open on both sides and is well lit and ventilated.
  • When the images are taken, you will hear tapping noises. So that the noise doesn’t bother you as much, you will be given headphones or earplugs.
  • Stay as still as possible. Most often you will be asked to hold your breath for a moment.
  • The medical team is outside the examination room but can always see you through a window and a camera.

If you want to reach the medical team during the examination, you can do so using a press button. They can then hear you through an intercom.

  • The examination takes twenty to thirty minutes, but in certain cases it may take an hour.

Considerations:

  • Carefully read the guidelines on the appointment letter for your MRI examination.
  • Complete the questionnaire on the appointment letter in advance and bring it with you to the examination. If anything is not clear, please contact your doctor to answer the questions together as correctly as possible.

If you have questions about the safety of the examination, for example, if you have certain implants (hearing implants, pacemakers …), do not hesitate to contact the medical imaging service.

  • You do not need to be fasting for this examination.
  • Please sign in at the hospital 45 minutes before your appointment.
  • Do not wear metal objects (jewellery, piercings, hairpins).
  • If you already have earplugs of your size at home, you can bring them with you to the examination.
  • In case of (suspected) pregnancy and/or piercings or jewellery that you cannot remove, it is important to notify the nurse.

Elongation and bending examination of the entire spine

X-ray images are taken during the elongation and bending examination.

Elongation examination

During this examination, you lie down on a special table where your pelvis is fixed. During the imaging, your head will be gently pulled to reposition the vertebrae.

During this examination, it is important that you lie calmly.

Bending examination

During this examination, you will be in a standing position with the body moving as far to the left or right as possible and then standing still in that position for the imaging.

Both of the above mentioned examinations can be uncomfortable but provide useful information about spinal stiffness.

MEP and SSEP examination (neurophysiological examination)

The MEP and SSEP examinations examine the nerve pathways in the spinal cord. Along these nerve pathways, signals are sent from the brain to the entire body and vice versa.

MEP (Motor Evoked Potential)

During the MEP examination, magnetic stimuli are given at the level of the head. After this, the response of your arm and leg muscles to these stimuli is recorded. In this way, the nerve pathways that provide movement can be examined.

The examination is usually well tolerated and takes about 30 minutes.

SSEP (Somatosensory Evoked Potential)

During the SSEP examination, short, harmless electrical impulses (stimuli) are applied to the skin of the hands and feet. This tests the sensory pathways between the site of the stimulus and the brain.

Just like the MEP examination, the SSEP examination is harmless and is usually well tolerated. This examination takes about 45 minutes.

On the day of the examination, a doctor or nurse will give you a detailed explanation of these examinations.

EMG (electromyography)

During an EMG, the function of the muscles and nerve pathways in the limbs is measured.

The test consists of two parts:

  • The nerve test: You will receive electrical stimulation to the nerves, feeling small shocks. The response of the nerve is then accurately measured.
  • The muscle test: a thin needle is inserted through the skin into the muscle, and you feel a prick. Depending on the muscle to be examined, you perform a certain movement for the doctor to see the action of the muscle on a computer screen.

The examination takes about thirty to forty minutes.

Considerations:

  • Make sure you are at the hospital 25 minutes before your appointment to register at least 10 minutes before your appointment.
  • You do not need to be fasting.
  • Clean your skin well with soap and water before the examination, but do not use skin creams.
  • Please mention before the examination whether you take blood thinners (and which ones), cortisone-containing medication (e.g., puffers, skin creams, Medrol …), and whether you have received injections in the back or joints in the past two to three months.

It is practical to bring a list with the names and doses of all the medicines you are taking.

Updated on December 11, 2023

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