Single, well centered lateral view of lumbosacral spine: is coned view necessary?

A single lateral view, centered 1 cm above the top of the palpable iliac crest, has been shown to adequately demonstrate the entire lumbar spine and lumbosacral junction in over 90% of patients, thereby eliminating the necessity to obtain both a full lateral and coned lateral view of the lumbosacral junction. Eliminating this extra film from the routine lumbosacral examination results in enormous savings in patient cost and patient radiation exposure, without sacrificing any diagnostic accuracy.