Nondiscogenic lumbar radiculopathy: imaging considerations.

This article reviews the differential diagnosis of lumbar radiculopathy, clinical presentations of spinal stenosis, pathological anatomy, and roentgenographic considerations of lumbar spinal stenosis. Most patients suspected of symptomatic spinal stenosis should have plain roentgenograms first to rule out other obvious lesions and to evaluate disc space and foraminal narrowing. Plain roentgenograms also show the sagittal and coronal deformities if present. The next procedure for the evaluation of spinal stenosis after plain roentgenograms should be MRI, as myelogram or CT can be avoided in most cases. In select cases, patients who cannot get MRI or those who underwent MRI with unresolved questions should have a myelogram or CT for further evaluation.