Optimum radiographic examination for consideration of compensation awards: II. Cervical and lumbar spines

In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for cervical and lumbar spine disease or injury claimed to be service-related. Results show that the final radiographic assessment could be made in 100% (245) of cervical spine examinations using two views (anteroposterior and lateral) and in 99.3% (699/704) of lumbar spine examinations using two views (anteroposterior and a single well centered lateral). Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examinations of the cervical and lumbar spines to these views would eliminate 193,000 radiographs in the evaluation of 100,000 applicants and yield an annual savings of about $1,000,000.