Angled Posteroanterior Fluoroscopy for L5-S1 Discography: A Technical Note

Lumbar discography, a useful modality for evaluating patients with lower back pain, is performed under fluoroscopy with posteroanterior and lateral fluoroscopic imaging. Despite use of fluoroscopy, needle placement into the L5–S1 disc may be difficult, especially in the presence of degenerative changes. We describe use of angled posteroanterior fluoroscopy with the fluoroscopy beam directed 30° to 40° caudally in a prone patient for clear visualization of the L5–S1 disc space. Use of this radiographic view aids in accurate needle placement and might decrease both procedure duration and fluoroscopic exposition.