We’re going to look at xrays and how they represent the lumbar spine in general xrays are taken on a front to back or back to front view and on a side view the xray front to back view is this one and you can see how that is relatively comparable to the model.
Where you have the vertebra lining up you see the vertebra lining up you have the sacrum down in this area here’s the sacrum the sacrum of course is connected to the pelvis through the sacroiliac joints on either side.
You can see the vertebra lineup straight and actually you can follow the ribs up on either side as they go into the thoraic spine up in this area on the side view you again can see the vertebra lining up one on top of another you cannot see the disc because there’s no bone in the disc but you can t get a good idea of what the disc looks like by the height and by the boney reaction to the disc.
How to Read a MRI of a Lumbar Herniated Disc Lower Back Pain Colorado Spine Surgeon
We’re going to look now at a lumbar spine MRI of a patient that has a disc herniation and again we see the side view spinal cord ending here nerve roots coming out and the white being cerebral spinal fluid the water these are the vertebra.
These are the discs the L one two two three and three four discs are normal the white on the inside the jelly is full of water the dark plies in the tire normal here at the four five level there is a degenerative disk you don’t see the normal white of a normal disc and you see a small tear in the back of the disc right.
There at the five one level it looks somewhat like the four five level as it’s dark in the disc but you can see a complete rupture at the back of the disc and a disc herniation here which is filling up the spinal canal this is a typical disc herniation.
You can look at it now from the topdown view and will come down to the five one level no better yet we will start at three four here and here is that jelly filled donut the normal jelly on the inside the donut on the outside the sack of nerves here all of these black dots are.
The nerve roots the back of the disc is flat to concave this is normal we come down from that level to the four five level and here is a small tear in the back of the disc this is called an annular tear but the nerves behind that tear are not compressed therefore this patient shouldn’t have any nerve pain from this tear we come down to the five one level.
And here we see a massive herniated disc you can see on the right side the nerve in some of the nerves in the right side are free and open on the left side you’ll see that this herniation.