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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.

The patient will lie on their stomach (prone position) on the X-ray table. The table may have an adjustable section to support the hips and abdomen, providing comfort and stability during the procedure.

3. 
   

   Alignment: The radiologist or technologist will assist the patient in aligning their body properly. This involves ensuring that the patient's spine is in a straight line, and the hips and shoulders are parallel to the table.

   
   


4. 
   

   Flexion or Extension: Depending on the specific requirements of the examination, the patient's spine may need to be flexed or extended. This is usually achieved by bending or straightening the patient's knees while keeping the upper body in a fixed position. The specific instructions will be provided by the radiologist or technologist.

   
   


5. 
   

   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. They may mark the skin to guide the insertion site.

   
   


6. 
   

   Injection of Contrast Agent: Once the correct level is identified, a local anesthetic may be administered to numb the skin and tissues. A thin needle is then inserted into the appropriate intervertebral space, and a contrast agent is injected. The contrast agent helps visualize the spinal cord and nerve roots during the subsequent X-ray imaging