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Lumbosacral spine x-ray

X-ray - lumbosacral spine; X-ray - lower spine

A lumbosacral spine x-ray is a picture of the small bones (vertebrae) in the lower part of the spine. This area includes the lumbar region and the sacrum, the area that connects the spine to the pelvis.

How the Test is Performed

The test is done in a hospital x-ray department or your health care provider's office by an x-ray technician. You will be asked to lie on the x-ray table in different positions. If the x-ray is being done to diagnose an injury, care will be taken to prevent further injury.

The x-ray machine will be placed over the lower part of your spine. You will be asked to hold your breath as the picture is taken so that the image will not be blurry. In most cases, 3 to 5 pictures are taken.

How to Prepare for the Test

Tell the provider if you are pregnant. Take off all jewelry.

How the Test will Feel

There is rarely any discomfort when having an x-ray, although the table may be cold.

Why the Test is Performed

Often, the provider will treat a person with low back pain for 4 to 8 weeks before ordering an x-ray.

The most common reason for lumbosacral spine x-ray is to look for the cause of low back pain that:

  • Occurs after injury
  • Is severe
  • Does not go away after 4 to 8 weeks
  • Is present in an older person

What Abnormal Results Mean

Lumbosacral spine x-rays may show:

  • Abnormal curves of the spine
  • Abnormal wear on the cartilage and bones of the lower spine, such as bone spurs and narrowing of the joints between the vertebrae
  • Cancer (although cancer often cannot be seen on this type of x-ray)
  • Fractures
  • Signs of thinning bones (osteoporosis)
  • Spondylolisthesis, in which a bone (vertebra) in the lower part of the spine slips out of the proper position onto the bone below it

Though some of these findings may be seen on an x-ray, they are not always the cause of back pain.

Many problems in the spine cannot be diagnosed using a lumbosacral x-ray, including:

Risks

There is low radiation exposure. X-ray machines are checked often to make sure they are as safe as possible. Most experts feel that the risk is low compared with the benefits.

Pregnant women should not be exposed to radiation, if at all possible. Care should be taken before children receive x-rays.

Considerations

There are some back problems that an x-ray will not find. That is because they involve the muscles, nerves, and other soft tissues. A lumbosacral spine CT or lumbosacral spine MRI are better options for soft tissue problems.

References

Bearcroft PWP, Hopper MA. Imaging techniques and fundamental observations for the musculoskeletal system. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 6th ed. New York, NY: Elsevier Churchill Livingstone; 2015:chap 45.

Contreras F, Perez J, Jose J. Imaging overview. In: Miller MD, Thompson SR. eds. DeLee and Drez's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 7.

Parizel PM, Van Thielen T, van den Hauwe L, Van Goethem JW. Degenerative disease of the spine. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 6th ed. New York, NY: Elsevier Churchill Livingstone; 2015:chap 55.

Warner WC, Sawyer JR. Scoliosis and kyphosis. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 44.

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    • Skeletal spine

      Skeletal spine

      illustration

    • Vertebra, lumbar (low back)

      Vertebra, lumbar (low back)

      illustration

    • Vertebra, thoracic (mid back)

      Vertebra, thoracic (mid back)

      illustration

    • Vertebral column

      Vertebral column

      illustration

    • Sacrum

      Sacrum

      illustration

    • Posterior spinal anatomy

      Posterior spinal anatomy

      illustration

      • Skeletal spine

        Skeletal spine

        illustration

      • Vertebra, lumbar (low back)

        Vertebra, lumbar (low back)

        illustration

      • Vertebra, thoracic (mid back)

        Vertebra, thoracic (mid back)

        illustration

      • Vertebral column

        Vertebral column

        illustration

      • Sacrum

        Sacrum

        illustration

      • Posterior spinal anatomy

        Posterior spinal anatomy

        illustration

      Tests for Lumbosacral spine x-ray

       
       

      Review Date: 5/13/2019

      Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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