目的　探讨分析腰骶椎转移癌与腰椎间盘突出症鉴别诊断要点。方法　对 5例初诊为腰椎间盘突出症 ,最后确诊为腰骶椎转移癌的患者进行分析 ,找出误诊原因。结果　本组病例误诊率为 2 .87% (5 / 174) ,5例均在入院后确诊 ,4例获随访者 3例在 4～ 8个月后死亡。结论　正确诊断强调病史、体征和影像学检查三者结合 ,对怀疑为腰骶椎转移癌者应行 MRI检查 ,以明确诊断 Objective To analyze the main points of differential diagnosis of lumbosacral metastasis and lumbar disc herniation. Methods Five newly diagnosed patients with lumbar disc herniation and finally diagnosed with lumbar and vertebral metastases were analyzed to find out the reasons for misdiagnosis. Results The misdiagnosis rate in this group was 2.87% (5/174). 5 cases were diagnosed after admission. 3 cases were followed up and 3 cases died after 4 to 8 months. Conclusion The correct diagnosis emphasizes the combination of medical history, physical signs, and imaging examinations. MRI examination should be performed for suspected lumbar and vertebrae metastases to confirm the diagnosis.