![x ray cervical spine x ray cervical spine](https://compspinecare.com/wp-content/uploads/sites/109/2021/07/shutterstock_617560913-min-1600x1303.jpg)
Any disruption in the flow of these lines suggests either a bony or a ligamentous injury (Figure 5).įigure 5: Disruption in the shape of the AV line, that indicates injury, and in this case a fracture of the body of C7.Īn exception to this rule is a pseudo-subluxation of C2 and C3 in the pediatric population, which can cause confusion. Additionally, a third line (spino-laminar line), running along the base of spinous processes and up to the posterior aspect of the foramen magnum, must be visualized (Figure 4).įigure 4: Always assess (AV) anterior vertebral, (PV) posterior vertebral and (SL) spinolaminar lines, they should run smooth, without any disruptions, and should form a slight lordotic shape.Īll three lines should form a smooth and lordotic curve of the cervical spine. To check for proper alignment, look for a normal smooth lordotic curve and imagine two lines, each running along the anterior and posterior margins of vertebral bodies. (see Figure 3).įigure 3: Example of a slightly rotated not ideal lateral projection of the cervical spine in (A) and an x-ray of an ideal lateral projection in (B).
![x ray cervical spine x ray cervical spine](https://assets.cureus.com/uploads/figure/file/182769/article_river_325068f05fd711ebb4d9fd6a7cb88b7b-ab-2.png)
Facet joints are best visualized when we have a proper lateral projection. Next, check if the x-ray is a real lateral view, or if it is slightly rotated. At this point it is not easy to differentiate ‘ABCs’, because of all the acronyms across the field of medicine, but the ‘ABCs’ in this case stands for: A – alignment and adequacy, B – bone abnormalities, C – cartilage space assessment and S for soft tissues.Ī – Alignment and adequacy: First, visualize the spine from the base of the skull to the C7-Th1 junction. Inspection of the x-ray should be thorough, methodical and complete.
![x ray cervical spine x ray cervical spine](https://thumbs.dreamstime.com/z/spinal-ray-showing-vertebrae-discs-curvature-degeneration-abnormalities-ai-generated-307136548.jpg)
The lateral (cross-table) view is the most helpful x-ray study in diagnosing c-spine injuries. Shoulders can be depressed by pulling the arms down slowly and steadily, or if the patient is capable, asking them to depress one shoulder and lift the other hand above his head to achieve the swimmer’s position, which better visualizes the lower vertebrae.įigure 2: Two examples of a cervical x-ray that is not good enough for the evaluation of the possible injury of the neck. Such lesions that leave the trapezius muscle unopposed occur in the lower cervical region.
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By Dejvid Ahmetović and Gregor Prosen IntroductionĬ-spine x-ray interpretation is one of the fundamental skills of emergency physicians.