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)