An overview of radiography, computed tomography, and magnetic resonance imaging in the diagnosis of lumbar spine pathology.

When patients present with symptoms associated with lumbar spine pathology, often a series of diagnostic examinations of escalating sophistication are utilized. To obtain a diagnosis, the initial study is usually done on lumbar spine radiographs, which demonstrate gross bony pathologies, spinal alignment, and bone density. Frequently, additional high-cost invasive or noninvasive procedures may be required. Myelography is used to examine the spinal cord, nerve root bundles, and possible intrusion of the vertebral disk into the spinal canal. Computed tomography is most useful for imaging small bony structures and, when coupled with myelography, can demonstrate soft tissue abnormalities in the spinal canal. Magnetic resonance imaging is, however, the preferred modality for imaging soft tissue.