W2- C-Spine Viewing Images

Question 1

What is the main goal of routine radiological exam of the c-spine?

Answer 1

-“To identify or exclude anatomic abnormalities or disease processes of the spine.”

Question 2

C-spine Radiological Exam Indications. (11)

Answer 2

• Trauma
• Suspected instability
• UE symptoms
• Occipital HA
• ROM limitations
• Pre-op/Post-op
• Malignancies
• Arthropathy
• Suspected congenital abnormality
• Health conditions associated with spinal abnormality
• Monitoring known abnormality

Question 3

Radiological Exam of the c-spine occurs between what (2) points?

Answer 3

• Craniocervical junction

- Superior T1 endplate

Question 4

What are some common views performed during radiologic exam of the c-spine? (5)

Answer 4

• AP Lower C-spine
• Lateral
• AP Open mouth view (upper cervical stability)
• Right oblique
• Left oblique

Question 5

• Which view is performed to see the intervertebral foramen at the C-spine?
• Which view is performed to see the Z-joints at the C-spine?

Answer 5

• Oblique 45 degrees

- Lateral

Question 6

• Which view is performed to see the intervertebral foramen at the T-spine?
• Which view is performed to see the Z-joints at the T-spine?

Answer 6

• Lateral

- Oblique 70 degrees

Question 7

• Which view is performed to see the intervertebral foramen at the L-spine?
• Which view is performed to see the Z-joints at the L-spine?

Answer 7

• Lateral

- Oblique 45 degrees

Question 8

What are some things that are looked at in an AP view of the C-spine?

Answer 8

• Alignment: SPs, lateral bodies, lateral columns
• Ovular pedicles
• Interpedicular distance
• Distance from pedicle to SP
• Uncinate processes
• Radioluscent space of trachea in midline (if not midline, could indicate soft tissue mass pushing trachea)
• Disc space (better in lateral view)

Question 9

What are some things that are looked at in a lateral view of the C-spine?

Answer 9

• Smooth lines: A and P bodies, spinolaminar line, articular pillars
• Spatial relations: disk heights, TP over body
• Bodies box-like
• Normal atlantodental interval
• Z-joint spaces
• Alignment
• Atlanto-dens interval (radioluscent line between 2 structures)
• Superimposed TP over vertebral bodies

Question 10

What are the 3 parallel lines that we want to see in a lateral view of the c-spine?

Answer 10

1. ) Line extending down anterior border of vertebral bodies.
2. ) Line extending down posterior border of vertebral bodies.
3. ) Spinolaminar line.

Question 11

What is a common characteristic associated with spondylosis or degenerative changes seen in the lateral view?

Answer 11

superior/inferior lipping

Question 12

What is the Open-Mouth (Odontoid View) commonly used for?

Answer 12

Commonly used to look abnormalities associated with the upper c-spine (C1 and C2).

Question 13

What are some things that are looked at in the open-mouth view of the C-spine?

Answer 13

Spatial Relationship

• Atlas and Axis
• Lateral borders of lateral masses (C1) and superior z-joint surfaces axis
• SP of C2 midline

Symmetry

• Lateral masses C1
• Joint spaces C1/C2 z-joints

Continuity
-Anterior arch and dens

Question 14

What are right and left oblique images commonly used to view?

Answer 14

• Neuroforamen

- Pedicles

Question 15

• Which neuroforamen is seen with a right anterior oblique image?
• Which neuroforamen is seen with a left anterior oblique image?

Answer 15

• Right

- Left

Question 16

• Which neuroforamen is seen with a right posterior oblique image?
• Which neuroforamen is seen with a left posterior oblique image?

Answer 16

• Left

- Right

Question 17

What do flexion-extension stress views allow us to see?

Answer 17

How bones align with each other when a load is placed on them.