DSSP (imaging)

DSSP refers to Digital Subtraction Spinal Panography, a radiographic imaging technique used in medical diagnostics, primarily within orthopedics and chiropractic care. This method involves acquiring two separate X-ray images of the spine: one in a neutral position and another in a stressed or flexed position. These images are then digitally subtracted from each other to highlight subtle movements and instabilities within the spinal column that may not be apparent on standard static radiographs.

The principle behind DSSP lies in isolating the changes in bone alignment and intervertebral disc space that occur between the two image acquisitions. By subtracting the background bone structure and soft tissue, the technique aims to enhance the visibility of movement anomalies, such as excessive translation or rotation of vertebrae, or alterations in disc height during flexion/extension.

DSSP can be used to assess a variety of spinal conditions, including:

• Ligamentous instability: Ligament injuries can lead to abnormal spinal motion, which DSSP can help identify.
• Segmental dysfunction: DSSP may assist in pinpointing specific vertebral segments that are not moving properly.
• Degenerative disc disease: Changes in disc height and vertebral alignment associated with disc degeneration can be assessed.
• Post-traumatic instability: Following spinal trauma, DSSP can help evaluate the degree of instability.

While DSSP can provide valuable information, it's important to note that its interpretation requires specialized expertise. It is often used in conjunction with other diagnostic tools, such as MRI or CT scans, to provide a comprehensive assessment of the patient's condition. There is ongoing debate and research regarding the sensitivity, specificity, and overall clinical utility of DSSP compared to other imaging modalities.