Abstract

ABSTRACT: Data from 339 patients referred for evaluation of suspected lumbar disease were studied retrospectively to correlate findings in the routine clinical evaluation with results of computed tomography and myelography. Clinical features from the patients history that correlated with an abnormal CT and myelogram included age ≥40, a history of previous surgery, and absence of a history of injury. Signs from the physical examination that correlated included reduced lumbar motion, a motor or sensory deficit, abnormal reflexes, and reduced capacity for straight leg-raising or walking. Using a clinical score incorporating these variables, we suggest a diagnostic strategy to promote more efficient and selective use of CT scans and myelograms. We project that the use of this diagnostic approach can reduce the number of myelograms ordered in a similar population by more than 50%.