|
|
| Line 1: |
Line 1: |
| | | #REDIRECT [[C-Spine X-Ray]] |
| ==Background==
| |
| *Anatomy and general approach similar in plain films and CT
| |
| | |
| ==Plain films==
| |
| *Standard radiographs are thee-view trauma series
| |
| *Similar approach of reading plain films to ED screening of a c-spine CT
| |
| | |
| ==General==
| |
| *Most common approach is three parallel vertical column model by Denis
| |
| **Anterior column: alternating vertebral bodies and intervertebral disks surrouded by anulus fibrosus and anterior longitudinal ligament
| |
| **Middle column: poster parts of annulus fibrosis and posterior vertebral wall, posterior lognitudinal ligament, spinal cord, paired laminae and pedicles, articulating facets, transverse processes, nerve roots and vertebral arteries/veins
| |
| **Posterior column: spinous process, nuchal ligament, ineterpsinous and suprspinous ligaments, and ligamentum flavum.
| |
| | |
| [[File:Denis Spinal Columns.jpg|thumbnail]] | |
| http://radiopaedia.org/articles/three-column-concept-of-spinal-fractures
| |
| | |
| *Disruption: in one column - generally stable. in two columns - stable in one direction but unstable in another. in three columns - highly unstable.
| |
| | |
| ==Approach==
| |
| *Pneumonic: AABCDS
| |
| **Adequacy - ensure adequate visualization to C7-T1 interface
| |
| **Alignment - Assess alignment of 4 parallel lines
| |
| ***Anterior vertebral line
| |
| ***Posterior vertebral line
| |
| ***Spinolaminar line
| |
| ***Posterior spinous line
| |
| [https://www.med-ed.virginia.edu/Courses/rad/cspine/interpretation2.html Alignment of C-Spine]
| |
| **AOA - antlanto-occipital alignment - anterior margin of foraement magnum should line up with the dens
| |
| [https://www.med-ed.virginia.edu/Courses/rad/cspine/interpretation3.html Atlanto-occipital alignment]
| |
| ***Bony Landmarks - there should be an smooth outline to each of vertebrae
| |
| ***
| |
| | |
| | |
| | |
| ==Management==
| |
| | |
| ==Disposition==
| |
| | |
| ==See Also==
| |
| | |
| ==External Links==
| |
| | |
| ==References==
| |
| <references/>
| |
| http://nypemergency.org/reading_emergency_images/c-spine.html
| |
| https://www.med-ed.virginia.edu/Courses/rad/cspine/interpretation5.html
| |
