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Cervical spine series

Last revised by Tariq Walizai on 21 Jun 2024

Citation, DOI, disclosures and article data

Citation:

Murphy A, Walizai T, Vadera S, et al. Cervical spine series. Reference article, Radiopaedia.org (Accessed on 04 Oct 2024) https://doi.org/10.53347/rID-59935

DOI:

https://doi.org/10.53347/rID-59935

Permalink:

https://radiopaedia.org/articles/59935

rID:

59935

Article created:

30 Apr 2018, Andrew Murphy ◉

Disclosures:

At the time the article was created Andrew Murphy had no recorded disclosures.

View Andrew Murphy's current disclosures

Last revised:

21 Jun 2024, Tariq Walizai

Disclosures:

At the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.

View Tariq Walizai's current disclosures

Revisions:

8 times, by 6 contributors - see full revision history and disclosures

Systems:

Spine

Sections:

Radiography

The cervical spine series is a set of radiographs taken to investigate the bony structures of the cervical spine, albeit commonly replaced by the CT, the cervical spine series is an essential trauma radiograph for all radiographers to understand.

Indications

Cervical spine radiographs are indicated for a variety of settings including ^1-3:

trauma
infection
atypical pain
limb pain
osteoporosis
degenerative changes

A decision to pursue C-spine imaging of any kind should be cross-referenced with the 'Canadian C-Spine Rule' for C-spine imaging due to its high sensitivity and specificity ⁴.

Projections

Standard projections

Note: in the absence of CT 5 views of the C-spine should be performed: AP, lateral, obliques and odontoid ⁵.

AP
- anteroposterior projection of the cervical spine demonstrating the vertebral bodies and intervertebral spaces
lateral
- often utilised in trauma demonstrated
  - zygapophyseal joints
  - soft tissue structures around the c spine
  - spinous processes
  - anterior-posterior relationship of the vertebral bodies
odontoid
- also known as a 'peg' projection it demonstrates the C1 (atlas) and C2 (axis)
AP oblique
- demonstrates the intervertebral foramina of the side positioned further from the image receptor
PA oblique
- demonstrated the intervertebral foramina of the side positioned closer to the image receptor

Additional projections

cervicothoracic view (swimmer's view)
- modified lateral projection of the cervical spine to visualise the C7/T1 junction
flexion-extension lateral
- specialised projections of the cervical spine often requested to assess for spinal stability.
Fuchs view
- non-angled AP radiograph of C1 and C2. It should not be used in a trauma setting

References

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