Present a friendly and concise guide to the imaging diagnosis of degenerative lumbar disease. Review future perspectives from the diagnostic imaging point of view.

Lumbar degeneration is extremely frequent, being an unavoidable outcome result of the imbalance of mechanical loads, and morphological and biochemical changes of multifactorial origin (age, sex, environmental and genetic factors) affecting the spine. Involved structures include the intervertebral discs, vertebral endplates, facet joints, ligaments and spine musculature, which in a continuous process of degeneration / compensation give rise to different pathologies that are depicted in detail with the current imaging techniques.

To the date the magnetic resonance imaging (MRI) is the best imaging test to demonstrate the normal, pathologic and adaptive changes occurring in the spine, owing its high anatomic definition and greater tissue contrast compared with other techniques. Plain film tends to be the first study performed in clinical practice owing its high availability. It offers anatomic information of the bony spine and can suggest the need for further studies. Computed tomography (CT) offers excellent anatomic information, been of great value in emergency settings, surgical...

In the degenerating process of the lumbar spine many factors interact, resulting in biomechanical variations that give raise to different clinical scenarios. There is a strong correlation between clinical manifestations and radiological findings, making radiologists to play a critical role in the management of such patients. With the here proposed guide, radiologists will be able to review and report the vast majority of studies performed in patients with suspected degenerative disease.

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