Evaluating the Diagnostic and Clinical Value of Lumbar Spine CT: A Systematic Review

Abstract

Aims: To determine whether there are significant findings in CT lumbar spine imaging to justify the radiation dose delivered to organs and tissues in the abdominopelvic region and assess clinical validation for using alternatives such as plain film imaging or magnetic resonance imaging. Study Design: The study is a systematic review. Various published studies from PUBMED, MEDLINE, CINAHL and APA PsychINFO were used to gather data. A literature search was conducted using 4 reputable databases from the past years (2018 to 2022). An appraisal of the papers was conducted using the relevant CASP criteria to justify and validate the quality of the papers. 3 key themes emerged from the data and were prominent in the literature; they became the main foci. Results: Fracture, osteoporosis, and bone mineral density (BMD) are findings that are interlinked and related to diseases of the lumbar spine, and a CT was performed to identify them. Undetected lumbar spine fractures were apparent in the majority of osteoporotic patients; however, not all patients have been diagnosed with them. Using the information gathered from this review, checklists have been created to highlight criteria for diagnosing lumbar spine fractures, determining osteoporosis or in the assessment of bone mineral density. Guidelines must be adhered to before referring patients for CT imaging (or alternative imaging modalities such as X-ray, MRI or DXA). Patients need to be made aware of the potential side effects and shortcomings of these investigations. Conclusion: CT lumbar spine imaging still has a huge role to play in routine clinical practice, particularly in the detection of fractures. In the future, adequate information and support could be offered to referring doctors and physicians for diagnosing lumbar spine abnormalities.