Low back pain: the controversy of radiologic evaluation

A prospective study was performed to evaluate the efficacy of including oblique radiographs as part of a lumbar vertebral column examination. Five hundred patients in the second through ninth decades of life were evaluated. Of those, 12% had an abnormality detected on the 45 degree oblique view that was not apparent on the frontal or lateral radiographs. Those abnormalities included degenerative changes of apophyseal joints (6%), spondylolysis (4%), osteoid osteoma, anomalous apophyseal joint, and abnormal pars interarticularis (2%). These results are compared with those of other investigators and the reasons for variance are discussed.