Lumbar Vertebrae

Question 1

What’s the difference between transverse processes of thoracic spine and lumbar spine

Answer 1

Lumbar spine’s transverse processes are smaller than those of thoracic spine

Question 2

Lordosis

Answer 2

An increase in the lumbar curve

Question 3

Causes of Lordosis

Answer 3

1. Increased weight of abdomen
2. Poor posture
3. Rickets
4. Osteoporosis
5. TB of the spine

Question 4

Basic projections for lumbar spine

Answer 4

1. AP
2. Lateral

Question 5

Clinical indications for AP and lateral of lumbar spine

Answer 5

• Pathology of lumbar
• Trauma to rule out fracture
• Neoplastic processes

Question 6

AP projections

Answer 6

1. With extended hips and knees
2. With flexed knees and hips

Question 7

Preferences of AP with flexed knees and hips over extended hips and knees

Answer 7

• The intervertebral discs are visible in AP with flexed knees and hips which is vital for diagnosis than on extended hips and knees

Question 8

AP patient position of lumbar spine

Answer 8

1. IR 35×43
2. Lie the patient in supine and adjust the patient’s body to the center of the x-ray couch with hips and knees flexed.
3. Place the patient’s hands on the side of the body with the palmar aspect in contact with the x-ray couch.
4. The soles of the patient’s feet should be on the table to reduce the lumbar lordosis

Question 9

AP projection lumbar spine centering point

Answer 9

• 3rd lumbar vertebrae

Question 10

Special features to consider when doing AP of lumbar spine

Answer 10

1. Expose on arrested respiration
   2 Ffd of about 120cm

Question 11

Image evaluation criteria for AP of lumbar spine

Answer 11

• evidence of proper Collimation
• Area from the lower thoracic vertebrae to the sacrum should be visible
• X-ray beam collimated to the lateral margin of the psoas muscle
• No rotation, symmetric vertebral bodies with spinous processes centered to the Bodies, sacroiliac joints equidistant from the vertebral column
• Open intervertebral disc space
• Soft tissue and bony trabeculae detail

Question 12

Lateral of lumbar spine

Answer 12

*Patient lies in true lateral and centralised to
the couch with arms raised to the head.
*Support the head on a pillow.
*Knees and hips are flexed for
stability(immobilisation).
*Pads are placed in between the knees and
the hip for the patient’s comfort.
*A lead rubber piece is placed at the back of
the patient to absorb scattered radiation.

Question 13

Lateral of lumbar spine Centring point

Answer 13

• 10 cm in front of the lumbar spinous process at the level of the lower costal margin

Question 14

Image quality evaluation of lateral spine lumbar

Answer 14

*Evidence of proper collimation.
*Vertebrae aligned down the middle of the
image.
*No rotation
−Superimposed posterior margins of each
vertebral body.
−Nearly superimposed crests of the ilia when
the x-ray beam is not angled.
−Spinous processes in profile

Question 15

Supplementary projection

Answer 15

Oblique projections (both Right and Left

Question 16

indications for Oblique projections of the lumbar spine.

Answer 16

• Defects of the pars interarticularis (e.g.
  spondylolysis)

Question 17

Spondylosis

Answer 17

an acquired bony defect occurring
in the pars interarticularis

Question 18

pars interarticularis

Answer 18

the area of the lamina between the two articular processes

Question 19

Patient positioning of the oblique projections of lumbar spine.

Answer 19

• The patient is supine and rotated 45 degrees
  towards a side - left or right.
• The raised side is supported on foam pads.
• The pads are placed under the lower thorax and pelvis for support

Question 22

Centering point of the oblique projections of lumbar spine.

Answer 22

*Centre in turn in the mid-clavicular line on the
raised side at the level of the lower costal margin.

Question 23

Direction of c.ray

Answer 23

90 degrees to IR