A quarter of a century ago one of us (WPB) arrived as a Consultant Radiologist with a particular interest in the musculoskeletal system at St James's University Hospital in Leeds. Shortly thereafter, the other (RAD) took up the position of Professor of Orthopaedic Surgery in the same institution and from then on we have worked on a daily basis seeking to provide an optimal clinical service for patients in the Yorkshire region, and beyond, who have spinal problems. It became abundantly clear that imaging (all forms of X-rays and scans) was an essential partner to safe, sensible, well-intentioned spinal surgery with a minimal complication rate. Thus the spinal surgeon and the spinal radiologist must work together to produce clinical work of the highest quality. Back then, we instituted a regular weekly audit meeting (long before audit was ever envisaged) whereby all patients operated upon the following week were assessed clinically and radiologically by the spinal team (spinal surgeons, nurses, radiologists etc). This practice of course continues today although, mercifully, there is more than one spinal surgeon and one radiologist!

Because we emphasise in this text that, apart from red flag problems such as cancer, scanning in particular has to be surgically-directed, then the marrying up of clinical features with scan appearances is an absolutely essential pre-requisite before surgical intervention.