Simple X-rays are often useful in assessing the bones of the skull and spine. X-rays of the spine can be used to assess fractures or misalignment. Your surgeon may want additional imaging ' such as CT or MRI ' though workup often begins with X-rays. X-rays also are particularly useful in determining the stability of the spine. This is achieved by taking X-rays of the cervical or lumbar spine both in 'flexion' (bent forward at the neck or hips) and 'extension' (straightened at the neck or hips). The surgeon or radiologist will look for abnormal movement of the bones of the spine on these 'dynamic' images.