How to read a Lumber Spine X-Ray 

X-rays are very important while looking for the pathology of the lumber spine. There are three kinds of 

X-ray views are used to assess the lumber spine. 

These include 

1. Ap view, 

2. Lateral view
3. Oblique view   

For a better understanding of the lumber spine, pathology following points should be considered.

How to count lumber vertebrae

The first thing we have to do is to count lumber spine vertebrae

 

So here is the X-ray of the lumber spine showing both AP and Later view and the first thing to notice is to count vertebrae.

 

so as you see in the X-ray in Ap view, the vertebrae with the last rib are T12, so we start counting just below the vertebrae with the rib and mark it as L1.

So in the lateral view, we start above the sacrum bone marked in blue and move upwards.

Identify Local Anatomy, spinous process, transverse process, pedicles

look for the pedicles one on each side, the transverse process on the side of each vertebra, and the spinous process on the back of vertebrae.

Intervertebral Disc space 

The next step we look for is the intervertebral disc space, as we all know intervertebral disc act as a cushion and shocker absorber with increasing age the water content of the disc starts to reduce resulting in decreased space between vertebrae due to the lost height of the disc.

here is the normal anatomy of the intervertebral disc containing water content in the nucleus pulposus and strong annulus fibrosis surrounding it. 

so here is a picture of disc herniation causing impingement to the nerve causing symptoms.

Nerve foramen  

naksn

so in the next step, we look for the nerve foramen as you can clearly see there is a reduced space between L5 and S1.

Look for fracture, discontinuation, break or stress fracture, scoliosis, straightening of spine 

 

. 

so these are some conditions that cause back pain.