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CT, myelography, and phlebography in the detection of lumbar disk herniation: an analysis of the literature.

Despite the large number of reports on the relative usefulness of various radiographic procedures for the diagnosis of lumbar disk herniation, there has been no consensus of opinion on the best imaging procedure. Different study designs, including criteria for patient selection and retrospective consideration of patients who underwent surgery only, hamper direct comparisons between studies. A major drawback is the common use of "accuracy" as a measure of quality. We reviewed the CT, myelographic, and phlebographic findings in lumbar disk herniation published since 1970. After the reports were systematically classified and assessed for quality, the results became more coherent. Many results tend to be sensitive and not very specific. We found there was no clear difference in the overall diagnostic quality of phlebography, myelography, and CT.