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The investigation of lumbar disc prolapse should include:

  • lumbar MRI:
    • the definitive investigation if the facility is available

  • plain X-rays:
    • of limited benefit in the investigation of lumbar disc disease
    • may reveal loss of a disc space or spondylolisthesis
    • it is more important in excluding other causes, e.g. metastatic bony changes

  • radiculography:
    • may show a filling defect in the theca on an AP or lateral view
    • may show obliteration or displacement of the nerve root sleeve

  • spinal CT:
    • may detect small, laterally-placed protrusions which may be missed on radiculography
    • shows hypertrophied facet joints and the diameter of the spinal cord

  • electromyography:
    • denervation in the muscles supplied by the affected roots may be shown
    • a low specificity test

Last reviewed 10/2020