The thoracic spine series is comprised of two standard projections along with a range of additional projections depending on clinical indications. The series is often utilized in the context of trauma, postoperative imaging and for chronic conditions.

Radiographs of the thoracic spine are considered the basic primary imaging, having a far inferior diagnostic yield than that of CT and MRI ¹.

Indications

Thoracic spine radiographs are performed for a variety of indications including ^1,2:

• fall from a height of greater than 3 meters

• ejection from a motor vehicle or motorcycle

• neurological deficit

• postoperative imaging

• chronic conditions

• history of cancer and associated back pain

Projections

Standard projections

• AP view

  • images the entirety of the thoracic spine, which consists of twelve vertebrae

  • intervertebral joints are seen in profile

  • often performed erect unless otherwise indicated

• lateral view

  • intervertebral joints and neural foramen are open, with the superimposition of the posterior spinous processes

  • ideal projection when examining for suspected fractures and dislocations

Modified trauma projections

• horizontal beam lateral

  • visualization of thoracic vertebral bodies, pedicles, and facet joints taken supine

  • used in the context of trauma

Additional projections

• flexion-extension view

  • functional view used to assess spinal stability

• bolster view

  • specialized view for scoliosis, often performed under the guidance of an orthopedic surgeon