Lumbar spine series
Updates to Article Attributes
The lumbar spine series is comprised of two standard projections along with a range of additional projections depending on clinical indications. The series is often utilised in the context of trauma, post operativepostoperative imaging and for chronic conditions such as ankylosing spondylosis.
Lumbar spine x rays are the most commonly ordered radiographic investigation of the spine, however, it is widely documented that plain radiography is far inferior in the investigation of suspected lumbar spine pathology compared to that of MRI and CT 1.
Although lumbar spine xraysx-rays are a part of general back pain work upsworkups there is no evidence that obtaining x rays before other modalities will result in a superiorhigher patient outcomes 2.
Indications
Lumbar spine radiographs are performed for a variety of indications including 1,2:
fall from a height of greater than 3 metres
ejection from a motor vehicle or motorcycle
acute back pain
GCS less than 8
neurological deficit
postoperative imaging
chronic conditions
history of cancer and associated back pain
Projections
Standard projections
-
the entire lumbar spine should be visible, with a demonstration of T11/T12 superiorly and the sacrum inferiorly
often performed erect unless otherwise indicated
-
visualisation of lumbar vertebral bodies, pedicles, and facet joints
ideal projection when examining for suspected fractures
can be performed erect to
assesassess stable fracture (under a specialist's guidance)
Modified trauma projections
-
horizontal beam lateral
visualisation of lumbar vertebral bodies, pedicles, and facet joints taken supine
used in the context of trauma
Additional projections
-
used to visualise the articular facets and pars interarticularis of the lumbar spine
-
flexion
extension-extension view- functional view used to assess spinal stability
-<p>The <strong>lumbar spine series</strong> is comprised of two standard projections along with a range of additional projections depending on clinical indications. The series is often utilised in the context of trauma, post operative imaging and for chronic conditions such as <a title="Ankylosing spondylosis" href="/articles/ankylosing-spondylitis">ankylosing spondylosis</a>.</p><p>Lumbar spine x rays are the most commonly ordered radiographic investigation of the spine, however, it is widely documented that plain radiography is far inferior in the investigation of suspected lumbar spine pathology compared to that of MRI and CT <sup>1</sup>.</p><p>Although lumbar spine xrays are a part of general back pain work ups there is no evidence that obtaining x rays before other modalities will result in a superior patient outcomes <sup>2</sup>.</p><h4>Indications</h4><p>Lumbar spine radiographs are performed for a variety of indications including <sup>1,2</sup>:</p><ul>-<li><p>fall from a height of greater than 3 metres</p></li>-<li><p>ejection from a motor vehicle or motorcycle</p></li>-<li><p>acute back pain</p></li>-<li><p>GCS less than 8</p></li>-<li><p>neurological deficit</p></li>-<li><p>postoperative imaging</p></li>-<li><p>chronic conditions</p></li>-<li><p>history of cancer and associated back pain</p></li>- +<p>The <strong>lumbar spine series</strong> is comprised of two standard projections along with a range of additional projections depending on clinical indications. The series is often utilised in the context of trauma, postoperative imaging and for chronic conditions such as <a href="/articles/ankylosing-spondylitis">ankylosing spondylosis</a>.</p><p>Lumbar spine x rays are the most commonly ordered radiographic investigation of the spine, however, it is widely documented that plain radiography is far inferior in the investigation of suspected lumbar spine pathology compared to that of MRI and CT <sup>1</sup>.</p><p>Although lumbar spine x-rays are a part of general back pain workups there is no evidence that obtaining x rays before other modalities will result in higher patient outcomes <sup>2</sup>.</p><h4>Indications</h4><p>Lumbar spine radiographs are performed for a variety of indications including <sup>1,2</sup>:</p><ul>
- +<li>fall from a height of greater than 3 metres</li>
- +<li>ejection from a motor vehicle or motorcycle</li>
- +<li>acute back pain</li>
- +<li>GCS less than 8</li>
- +<li>neurological deficit</li>
- +<li>postoperative imaging</li>
- +<li>chronic conditions</li>
- +<li>history of cancer and associated back pain</li>
-<p><a title="Lumbar spine: AP view" href="/articles/lumbar-spine-ap-view">PA/AP view </a></p>-<ul>-<li><p>entire lumbar spine should be visible, with demonstration of T11/T12 superiorly and the sacrum inferiorly</p></li>-<li><p>often performed erect unless otherwise indicated</p></li>- +<a href="/articles/lumbar-spine-ap-view-1">PA/AP view </a><ul>
- +<li>the entire lumbar spine should be visible, with a demonstration of T11/T12 superiorly and the sacrum inferiorly</li>
- +<li>often performed erect unless otherwise indicated</li>
-<p><a title="Lumbar spine: lateral view" href="/articles/lumbar-spine-lateral-view-1">lateral view</a></p>-<ul>-<li><p>visualisation of lumbar vertebral bodies, pedicles, and facet joints</p></li>-<li><p>ideal projection when examining for suspected fractures</p></li>-<li><p>can be performed erect to asses stable fracture (under a specialist's guidance)</p></li>- +<a href="/articles/lumbar-spine-lateral-view-2">lateral view</a><ul>
- +<li>visualisation of lumbar vertebral bodies, pedicles, and facet joints</li>
- +<li>ideal projection when examining for suspected fractures</li>
- +<li>can be performed erect to assess stable fracture (under a specialist's guidance)</li>
-</ul><h5>Modified trauma projections</h5><ul><li>-<p>horizontal beam lateral</p>-<ul>-<li><p>visualisation of lumbar vertebral bodies, pedicles, and facet joints taken supine</p></li>-<li><p>used in the context of trauma</p></li>- +</ul><h5>Modified trauma projections</h5><ul><li>horizontal beam lateral<ul>
- +<li>visualisation of lumbar vertebral bodies, pedicles, and facet joints taken supine</li>
- +<li>used in the context of trauma</li>
-<p><a title="Lumbar spine: oblique view" href="/articles/lumbar-spine-oblique-view-1">oblique view</a></p>-<ul><li><p>used to visualise the articular facets and pars interarticularis of the lumbar spine</p></li></ul>- +<a href="/articles/lumbar-spine-oblique-view-2">oblique view</a><ul><li>used to visualise the articular facets and pars interarticularis of the lumbar spine</li></ul>
-<li>-<p>flexion extension view</p>-<ul><li>functional view used to assess spinal stability</li></ul>- +<li>flexion-extension view<ul><li>functional view used to assess spinal stability</li></ul>
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