Cervical spine x-ray interpretation

RULES (normal)

1. Post vert > ant vert + 3mm
2. Predental space < 3mm
   1. < 5mm in children
3. Spinal canal narrowest point should be >13mm (lateral)
4. Anterior Soft tissue
   1. at C1-C4 < 7mm
   2. at C5-T1 < 22mm

PEDS

1. Children <8yo
2. ~50% SCI have no x-ray changes
3. most higher than C3
4. Pseudosubluxation (peds) = C2 on C3 posterior cervical line (nl = <2mm)

LATERAL

Alignment: Anterior, posterior, middle arcs

Bones: Vertebrae and spinous processes uniformity and height

Cartilage:intervertebral disc space height and length

Soft tissue: prevertebral soft tissue width

AP VIEW

Aligment of spinous processes

Distance between spinous processes

Uniformity and height of vertebrae

ODONTOID

Spacing of dens and lateral masses

Lateral aligment of C1 and C2

Uniformity of bones

Source

4/11/06 DONALDSON (adapted from Lampe, Rosen)