→ Intervertebral disk prolapse/herniation Intervertebral disk: type 2 herniation, (myelography required to confirm spinal cord compression).→ Spinal deformities Spine: butterfly vertebrae.→ Fractures Spine: fracture / luxation, with or without dislocation.The film must be correctly exposed and processed and show the anatomical marker, the patient's identification, the date, and the name of the hospital or practice.The objective is to produce radiographs showing the area of interest without rotation of the vertebrae or artificial narrowing of the disk spaces.With practice, it becomes possible to pinpoint features which do not benefit from easily palpable localizing landmarks.Ī secondary radiation grid should be used for patients >10 cm in thickness.
Accurate centring and collimation in the spine depends more on experience than radiography of most other areas of the body.Pinpoint landmarks, such as sternum/spinous processes, with your fingers and then check that the fingers are in the same plane. In judging whether a patient is positioned without rotation it is worth bringing eye level down to patient level.Radiography of a large number of vertebrae on one film is to be avoided, as the oblique rays towards the periphery of the beam will not pass through the disk spaces, with the result that spaces may appear artefactually narrowed.It is important to remember to avoid rotation of the spine in the craniocaudal direction, as well as the ventrodorsal direction.To achieve accurate positioning it is necessary to consider the whole patient, rather than focussing only on the area of interest.In the cervical region, satisfactory positioning is usually not possible without a general anesthetic.Successful radiography of the spine requires strict attention to the details of positioning.Higher quality images can be obtained following an initial assessment of the extent of the problem.Great care must be taken when handling and positioning a patient with a possible instability of the spine.Īn initial lateral survey film (without undue manipulation of the patient), may be appropriate.