Lumbar spine imaging is one of the procedures with the highest patient radiation dose.1 The possibility of dose reduction to the patient with the use of the posterior- anterior (PA) projection has been explored for a number of radiographic procedures.2-4 Over many years, several studies have noted that the radiation dose is reduced for postero-anterior (PA) projections of the lumbar spine when compared to antero-posterior (AP) projections (Fig. 1). Despite the abundance of research the AP remains the most widely used projection. Debate exists regarding any implications from switching between AP and PA projections on the resultant image quality. This systematic review aims to compare PA and AP lumbar spine radiography in terms of radiation dose to the patient and the resultant image quality.
