The patient will lie on their stomach (prone position) on the X-ray table.Localization and Marking: The radiologist or technologist will use anatomical landmarks and/or fluoroscopy (real-time X-ray imaging) to identify the correct lumbar level for the injection of the contrast agent.Flexion or Extension: Depending on the specific requirements of the examination, the patient's spine may need to be flexed or extended.Injection of Contrast Agent: Once the correct level is identified, a local anesthetic may be administered to numb the skin and tissues.The contrast agent helps visualize the spinal cord and nerve roots during the subsequent X-ray imaging3.4.5.6.