High-resolution computed tomography of the lumbar spine.

High-resolution computed tomography (CT) has dramatically expanded the understanding of lumbar spine anatomy. The procedure provides accurate preoperative assessment of bony and soft tissue pathology; directly visualizes the pathologic processes affecting the spine; and furnishes direct evidence of nerve root involvement by bony stenosis, herniated disc, and postoperative perineural fibrosis. The bony spinal and intervertebral nerve root canals and soft tissues can be imaged, herniated and sequestered discs identified, and causes of postoperative pain syndrome differentiated. High-resolution CT defines nerve root entrapment more accurately than any other imaging method currently used in the study of lumbar spine disease. Because it can provide complete preoperative information regarding bone and soft tissue pathology, the procedure can reasonably be expected to significantly reduce the incidence of "failed back surgery syndrome."