Both computed tomography (CT) and magnetic resonance imaging (MRI) scans are used for the diagnosis of lumbar nerve root canal stenosis by imaging measurement, but the findings have considerable variability and the specificity of these examinations is difficult to estimate. A prospective study was conducted to determine the association between epidurography and multispiral CT scanning and the diagnosis of lumbar nerve root canal stenosis. Twenty-nine patients underwent multispiral computed tomography epidurographies from December 2007 to October 2008, and among them 26 patients underwent all 3 examinations of CT, MRI, and multispiral computed tomography epidurography. Twenty-three patients underwent surgical treatment. The imaging features were investigated, and the sensitivity, specificity and total consistency rates were analyzed. Multispiral computed tomography epidurographies show the extent of soft-tissue as well as bone. The sensitivity of CTs, MRIs, and multispiral computed tomography epidurographies is 76.5%, 88.2% and 94.1%, specificity 60.0%, 60.0%, and 80.0%, and total consistent rate 72.7%, 81.0%, and 90.9%, respectively, for diagnosis of lumbar nerve root canal stenosis. Multispiral computed tomography epidurography could obtain the image findings giving consideration to both bone and soft-tissue by contrast medium and 3-dimensional reconstruction. Multispiral computed tomography epidurography was used because of its contrast medium distribution rather than its imaging measurement because it could avoid the variability between image findings and clinical pathological process. Multispiral computed tomography epidurography had better imaging characteristics for the diagnosis of lumbar nerve root canal stenosis than CT or MRI scans. Copyright © 2010 SLACK Inc. All Rights Reserved.