Normal Lumbar Spine X-Ray Report Template
Normal lumbar spine radiograph report template: alignment, vertebral body heights, disc spaces and sacroiliac joints, with wording for transitional anatomy.
EXAMINATION: Lumbar spine radiograph, 2 views. CLINICAL HISTORY: [indication] COMPARISON: None available. TECHNIQUE: AP and lateral views of the lumbar spine. FINDINGS: Alignment: Normal lumbar lordosis. No spondylolisthesis. Vertebrae: Five lumbar-type vertebral bodies with preserved heights. No acute fracture. Disc spaces: Preserved. Posterior elements: Intact. No pars defect identified. Sacroiliac joints: Unremarkable. Soft tissues: Unremarkable. IMPRESSION: 1. No acute fracture or malalignment of the lumbar spine.
Dictation notes
- Count and state the vertebral bodies when anatomy is transitional; name the convention used.
- On limited or single-view studies, say which views were obtained and qualify the fracture statement accordingly.
Frequently asked questions
What belongs in a normal lumbar spine X-ray report?
A normal lumbar spine radiograph report addresses alignment (normal lordosis, no spondylolisthesis), vertebral body count and heights, disc spaces, the posterior elements including the pars interarticularis, the sacroiliac joints and soft tissues. A standard series is AP and lateral views. The normal impression is 'No acute fracture or malalignment of the lumbar spine.'
How should transitional lumbosacral anatomy be reported?
When the anatomy is transitional — a lumbarized S1 or sacralized L5 — the report should count and state the vertebral bodies and name the numbering convention used. Ambiguous numbering has led to wrong-level surgery, so consistency between the radiology report, prior studies and the surgical plan matters more than which convention is chosen. Stating the convention lets every later reader reconcile levels.
How should a limited or single-view lumbar spine study be reported?
The report should state exactly which views were obtained and qualify the fracture statement accordingly — for example, 'no acute fracture on this single lateral view.' A fracture cannot be fully excluded without orthogonal views, and an unqualified negative overstates what the study can show. The same principle applies when anatomy is obscured by overlying bowel gas or patient positioning.
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