1 2 3 4
Fig. 3
C-Spine X-ray
Checklist (Adults)
A.. Lateral c-spine - keep hard collar on.
- adequacy of film - see all of C7, top of T1. If "No" -
continue anyway. Repeat films if no fracture.
- Alignment - Fig. 1 - line 1 - continues along ant. odontoid
- Line 2 - continues along posterior odontoid
- Line 3 – connects
laminae
- Line 4 note C1 should not reach this line
- Soft tissue thickness < 5 mm at C2 a <22 mm at C6
- atlanto-odontoid space:
3 mm or less
- Bones - check for
fractures. Shape of C3-C7 vertebral body should be approx. the same as
the one above and below.
If
a fracture is seen - do no further views - immobilize and transfer
B.
If lateral is normal, remove
immobilization and proceed with more
views
Odontoid view: Fig.
2
- Alignment of lateral
masses (arrows)
- Odontoid fracture - 3 types shown
PA view: Fig.
4
- Alignment of spinous processes only
C. Obliques -Useful for unilateral facet dislocations -Foraminae
all intact Fig.3
- Laminae line up like"shingles on a roof"
D. Flexion-extension
views -for further reassurance if other views normal. Use lat
c-spine checklist.
Some injuries not obvious on initial lateral will be visible on a lateral view.
Source:
Stobbe,
Karl. Can j Rural Med 2004; 9 (1)