MODULE 2

Cervical Spine

Normal Anatomy: typical and atypical features

• Extraspinal points of assessment– Sella turcica - maximum 16 X 12, double

floor sign, any erosion– Lung apices– paravertebral calcification - carotid

bifurcation• Can’t see vertebral artery calcification

Series

• Minimum - three (APOM, APLC, Lateral)

• Standard - five (APOM, APLC, Lateral, Right/Left Obliques with radiating signs and symptoms)

• Alternative - (APOM, APLC, Lateral, Flexion/Extension to document motion and stability)

• Standard - seven (Trauma series, 9 views)

Most underutilized study is the Pillar view

• Most common cervical spine fracture is facets• 17% cervical fracture at C7• 6/10 fractures found• 2.4 fractures are the average

You see a cervical spine fracture, stabilize and

transport. Stop the series.

Lines of Mensuration

• ADI

• Decrease degenerative joint disease

• Increase trauma

• occipitalization

• Down’s Syndrome– 20% born without transverse ligament – 25% have small posterior arch

Lines of Mensuration Continued

• Pharyngeal infection

• Ankylosing spondylitis

• Rheumatoid arthritis

• Psoriasis

• Reiter’s

Lines of Mensuration Continued

• George’s Line

• Posterior Cervical Line (spinolaminar joint line)

• Sagittal diameter, not useful

• Atlanto-axial alignment– C1 fracture

• Cervical spine gravity line