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
Fractures
Compression fractures of the back are broken vertebrae. Vertebrae are the bones of the spine.
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Signs of thinning bones (osteoporosis)
Osteoporosis
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
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Spondylolisthesis, in which a bone (vertebra) in the lower part of the spine slips out of the proper position onto the bone below it
Spondylolisthesis
Spondylolisthesis is a condition in which a bone (vertebra) in the spine moves forward out of the proper position onto the bone below it.

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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:

Sciatica
Sciatica
Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symp...
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Slipped or herniated disc
Slipped or herniated disc
A herniated (slipped) disk occurs when all or part of a disk is forced through a weakened part of the disk. This may place pressure on nearby nerves...
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Spinal stenosis - narrowing of the spinal column
Spinal stenosis
Spinal stenosis is narrowing of the spinal column that causes pressure on the spinal cord, or narrowing of the openings (called neural foramina) wher...
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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.

Open References

References

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

Kapoor G, Toms AP. Current status of imaging of the musculoskeletal system. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 38.

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. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 48.

Warner WC, Sawyer JR. Scoliosis and kyphosis. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 44.

Skeletal spine - illustration
The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.
Skeletal spine
illustration
Vertebra, lumbar (low back) - illustration
These are the five vertebra of the lower back. The last vertebra (on the upper left of the picture) attaches to the sacrum, and the top vertebra (on the right of the picture) attaches to the thoracic section of the back. The vertebra are broader and stronger than the other bones in the spine. This allows them to absorb the added pressure applied to the lower back, but this area remains a common site of injury. The vertebra are numbered from one to five and are labeled L1, L2, L3 etc. from the higher bones to the lower.
Vertebra, lumbar (low back)
illustration
Vertebra, thoracic (mid back) - illustration
These are twelve vertebra of the mid back. The last vertebra (on the left side of the picture) attaches to the lumbar (lower) spine, and the top vertebra (on the right) attaches to the cervical (neck) section of the back. The vertebra are broader and stronger than the cervical bones. This allows them to absorb the added pressure applied to the mid back, but they remain a common sight of injury. The vertebra are numbered from one to twelve and labeled T1, T2, T3, et cetera, from the upper most bones to the lowest.
Vertebra, thoracic (mid back)
illustration
Vertebral column - illustration
This is the spine and the sacrum with the cervical (neck), thoracic (mid-back), and lumbar (lower back) vertebra. Notice how the appearance of the vertebra change as you look down the spine. The change in shape and size reflect the different functions of the neck, mid-back, and lower back.
Vertebral column
illustration
Sacrum - illustration
The sacrum is a shield-shaped bony structure that is located at the base of the lumbar vertebrae and that is connected to the pelvis. The sacrum forms the posterior pelvic wall and strengthens and stabilizes the pelvis. Joined at the very end of the sacrum are two to four tiny, partially fused vertebrae known as the coccyx or tail bone. The coccyx provides slight support for the pelvic organs but actually is a bone of little use.
Sacrum
illustration
Posterior spinal anatomy - illustration
The vertebral column is divided into the cervical, thoracic, and lumbar region. It provides structural support for the trunk and surrounds and protects the spinal cord. The vertebral column also provides attachment points for the muscles of the back and ribs.
Posterior spinal anatomy
illustration

Skeletal spine - illustration
The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.
Skeletal spine
illustration
Vertebra, lumbar (low back) - illustration
These are the five vertebra of the lower back. The last vertebra (on the upper left of the picture) attaches to the sacrum, and the top vertebra (on the right of the picture) attaches to the thoracic section of the back. The vertebra are broader and stronger than the other bones in the spine. This allows them to absorb the added pressure applied to the lower back, but this area remains a common site of injury. The vertebra are numbered from one to five and are labeled L1, L2, L3 etc. from the higher bones to the lower.
Vertebra, lumbar (low back)
illustration
Vertebra, thoracic (mid back) - illustration
These are twelve vertebra of the mid back. The last vertebra (on the left side of the picture) attaches to the lumbar (lower) spine, and the top vertebra (on the right) attaches to the cervical (neck) section of the back. The vertebra are broader and stronger than the cervical bones. This allows them to absorb the added pressure applied to the mid back, but they remain a common sight of injury. The vertebra are numbered from one to twelve and labeled T1, T2, T3, et cetera, from the upper most bones to the lowest.
Vertebra, thoracic (mid back)
illustration
Vertebral column - illustration
This is the spine and the sacrum with the cervical (neck), thoracic (mid-back), and lumbar (lower back) vertebra. Notice how the appearance of the vertebra change as you look down the spine. The change in shape and size reflect the different functions of the neck, mid-back, and lower back.
Vertebral column
illustration
Sacrum - illustration
The sacrum is a shield-shaped bony structure that is located at the base of the lumbar vertebrae and that is connected to the pelvis. The sacrum forms the posterior pelvic wall and strengthens and stabilizes the pelvis. Joined at the very end of the sacrum are two to four tiny, partially fused vertebrae known as the coccyx or tail bone. The coccyx provides slight support for the pelvic organs but actually is a bone of little use.
Sacrum
illustration
Posterior spinal anatomy - illustration
The vertebral column is divided into the cervical, thoracic, and lumbar region. It provides structural support for the trunk and surrounds and protects the spinal cord. The vertebral column also provides attachment points for the muscles of the back and ribs.
Posterior spinal anatomy
illustration

A Closer Look

Talking to your MD

Self Care

Tests for Lumbosacral spine x-ray

Review Date: 5/3/2021

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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Health Library

Lumbosacral spine x-ray

x-ray

How the Test is Performed

How to Prepare for the Test

How the Test will Feel

Why the Test is Performed

What Abnormal Results Mean

Fractures

Osteoporosis

Spondylolisthesis

Sciatica

Slipped or herniated disc

Spinal stenosis

Risks

Considerations

References

Skeletal spine - illustration

Skeletal spine

Vertebra, lumbar (low back) - illustration

Vertebra, lumbar (low back)

Vertebra, thoracic (mid back) - illustration

Vertebra, thoracic (mid back)

Vertebral column - illustration

Vertebral column

Sacrum - illustration

Sacrum

Posterior spinal anatomy - illustration

Posterior spinal anatomy