Advanced diagnostic tools to identify your spine problems


“As with my first visit 12 years ago, I’m satisfied – Dr. Marano takes the time to see what and where my problems were coming from.”


Before Dr. Marano can effectively treat your spine problem, he must determine the root cause of your spine issue(s). He may use one or more advanced tests and tools to assist him in his diagnosis.

Magnetic Resonance Image (MRI) – A noninvasive test using a powerful magnetic field, radio frequency pulses and a computer to create detailed pictures of any internal body structure.

An MRI of the spine shows the anatomy of the bony structures that make up the spine, as well as the discs, spinal cord, ligaments, joints and the openings between the vertebrae through which nerves pass. MRI is the most sensitive imaging test of the spine and is the most commonly used test in routine clinical practice.

For more information on MRIs, click here.

Myelography – An imaging exam that involves injecting a contrast dye into the spinal sack that contains the spinal cord and nerve roots, to better see the component structures of the spinal column using a real-time X-ray and Computed Tomography (CT).

Myelography is most commonly used to detect irregularities affecting the bony spinal canal, nerve roots, discs, ligaments and joints, including the ability to:

  • Show whether a herniation of the intervertebral disc or bony spurs are compressing the nerve roots or the spinal cord.
  • Show a condition that often accompanies degeneration of the bones and soft tissues surrounding the spinal canal, termed spinal stenosis.

Myelography can also be used to assess some conditions when MRI imaging cannot be performed, or in addition to MRI (when MRI does not provide sufficient information).

For more information on myelography, click here.

Nerve Blocks – An anti-inflammatory medication along with a numbing agent is injected so it is targeted toward a certain nerve or group of nerves. The goal is to “turn off” a pain signal or to decrease inflammation. By “turning off” the pain “generator,” Dr. Marano can identify the problem’s location, and if needed, recommend a long-term solution.

Cervical Selective Nerve Root Block



For more information on nerve blocks, click here.

Epidural Injections – An injection of steroids (anti-inflammatory medications) and/or anesthetics into the epidural space to provide temporary or prolonged relief from pain or inflammation due to pinched or damaged nerves. If the injection provides relief, Dr. Marano then knows the problem’s location and can recommend a long-term solution.

Cervical Epidural Steroid Injection



Lumbar Epidural Steroid Injection



For more information on epidural injections, click here.

Computerized Tomography (CT) – A procedure that combines several X-ray images with the aid of a computer to create cross-sectional views and, if needed, three-dimensional images of certain areas of the spine.

CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When the image slices are reassembled by computer software, the result is a detailed three-dimensional (3D) view of the spine.

For more information on CT imaging, click here.

Bone Density Scan – Also called dual-energy x-ray absorptiometry (DXA) or bone densitometry, is an enhanced X-ray to measure bone loss, most often in the lower spine and hips. DXA is most often used to diagnose osteoporosis.

For more information on bone density scans, click here.

Discograms – An enhanced X-ray of the intervertebral discs. Dye is injected into the center of the injured disc(s). The dye makes the disc visible on X-ray film and on a special X-ray TV screen.

Discograms are used to determine which disc has structural damage and whether it is causing pain. A discogram can show if a disc has begun to rupture and if it has tears in the tough outer ring.

For more information on discograms, click here.

Vertebroplasty – A minimally invasive procedure to treat painful vertebral compression fractures (VCF) – fractures involving the spinal column vertebrae. Image guidance is used to inject a cement mixture into the fractured bone through a hollow needle.

For more information on vertebroplasty, click here.

Dynamic X-ray – Uses X-ray techniques to obtain measurements of your spinal alignment to assess joint weakness or incomplete bone formation. Dynamic x-rays are taken in a standing position while bending backward and forward to put your spine under an increased amount of stress.

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