Comparative Analysis of Lateral Radiography and Magnetic Resonance Imaging in the Diagnosis of Lumbar Disc Herniation

Aim: This article investigates the use of X-ray as a cost-effective and feasible alternative to magnetic resonance imaging (MRI) for diagnosing lumbar disc herniation (LDH), a common condition with significant economic impact. Material and Method: We assessed the diagnostic efficacy of lumbar lateral radiography (LLR) in identifying LDH. The study cohort formed from patients, presenting with lumbalgia or lumbosciatalgia. Participants who gave consent and had both MRI and LLR within a one-month period were included. Data normality was evaluated, employing the Kolmogorov-Smirnov test for nonparametric data. Variables were represented as means ± standard deviation, analyzed using the Wilcoxon test, with a p-value of less than 0.05 indicating statistical significance. Results: The study involved 436 patients, 56.8% female and 43.2% male, ranging in age from 18 to 75 years. No significant gender, age, or Body Mass Index (BMI)-related differences were observed in the presence of LDH on radiographs. However, significant differences were noted at the L5-S1 and L4-L5 levels. The LLR showed a sensitivity of 94%, specificity of 95%, and a high agreement of 96.7% among evaluators. Conclusion: Study concludes that LLR achieves a diagnostic success rate comparable to Lumbar MRI for most LDH cases. Notably, it is crucial to employ LLR even in patients presenting with "red flag" signs. LLR stands out as a cost-effective and rapid diagnostic alternative in the assessment of LDH. Nonetheless, it is important to acknowledge that MRI continues to be indispensable in more complex cases or for patients exhibiting specific clinical symptoms.