Lumbosacral Vertebrae Flashcards
- Supine
- Reduce lumbar lordosis by flexing the patient’s hip and knees enough to place the back in firm contact with table.
- CR: Perpendicular, level of the iliac crests.
- shows the lumbosacral vertebrae,
lumbar bodies, intervertebral disk spaces, interpediculate spaces, laminae, and spinous and transverse processes.
AP PROJECTION
- lateral position, flexing the hips and knees to a comfortable position.
- Place a radiolucent support under waist.
- CR: Perpendicular to the level of the crest of the ilium or L4.
- In some instances, angle the tube caudal 5 degrees for men, and 8 degrees for women with a wide pelvis
- shows the lumbar bodies and their interspaces, the spinous processes, the lumbosacral junction, the intervertebral foramina of L 1 -L4. The L5-S1 intervertebral foramina are not usually well visualized.
LATERAL PROJECTION
R or L position
- Lateral Recumbent Position
- CR: Directed to coronal plane 2 inches posterior to the ASIS and 1.5 inches inferior to the iliac crest.
- When the spine is not in the true horizontal position, the central ray is angled 5 degrees caudad for male patients and 8 degrees caudad for female patients.
- show a lateral projection of the lumbosacral junction, the lower one or two lumbar vertebrae, and the upper sacrum.
LATERAL PROJECTION
(L5-S1 Lumbosacral Junction)
- patient turn from the supine position toward the affected side approximately 45 degree to demonstrates the joints closest to the IR (opposite the thoracic zygapophyseal joints) and at an angle of 30 degree to demonstrates the lumbosacral processes.
- shows an oblique projection of the lumbar and/or lumbosacral spine, demonstrating the
articular processes of the side closest to the IR. - appearance of Scottie dogs.
AP OBLIQUE PROJECTION
RPO and LPO Positions
- CR: For Lumbar Region RPO LPO
Enter 2 inches medial to the elevated ASIS and 1.5 inches above the iliac crest (L3).
- For 5th Zygapophyseal Joint RPO LPO
Enter 2 inches medial to the elevated ASIS and then up to a point midway between the iliac crest and the ASIS.
demonstrating L5 zygapophyseal joint (arrows) using a 30-degree position.
RPO position
shows joints farthest from the IR are demonstrated
PA Oblique Projecion: LAO
CR used for the general lumbar
region
45°
CR if interest is specifically focused on L1 or L2, the degree of rotation should be increased to at least
50
CR If interest is in the L5-S1 area, rotation would be only about
30
- patient in the lateral position, rotate the pelvis 30 degrees anteriorly.
- CR: Directed along a straight line extending from the superior edge of the crest of the uppermost ilium through L5 to the inguinal region of the dependent side.
- CR: angulation may vary from 15 to 30 degrees caudad.
- shows the L5 intervertebral foramen.
PA AXIAL OBLIQUE PROJECTION / KOVACS METHOD
RAO and LAO positions
