Lumbar Spine

What is the film size for AP LS Spine?

14x17 LW (LS Spine)

How is the patient positioned for AP LS Spine?

Supine, midsagittal plane centered to IR, shoulders and hips aligned, arms at patient’s side

How is the part positioned for AP LS Spine?

Flex hips and knees to reduce lumbar curvature, support knees, flex knees before CR entry

Where is the central ray directed for AP LS Spine?

90° to iliac crest (L4)

What anatomy is demonstrated on AP LS Spine?

T12, SI joints, sacrum, coccyx, lumbar vertebral bodies, spinous processes, pedicles, intervertebral disk spaces

What is the film size for AP Axial (Upshot) L5-S1 / SI joints?

10x12 CW

How is the patient positioned for AP Axial L5-S1?

Supine, midsagittal plane centered to IR, shoulders and hips aligned, arms at patient’s side

How is the part positioned for AP Axial L5-S1?

Extend patient’s legs, center IR to level of iliac crest

Where is the central ray directed for AP Axial L5-S1?

Angle 30° male / 35° female cephalad, entering approx 3" inferior to iliac crest at level of ASIS (S2)

What anatomy is demonstrated on AP Axial L5-S1?

L5-S1 intervertebral disk space, sacrum, SI joints

What projections are included in PA Oblique Lumbar Spine?

AP Oblique LS Spine (RPO & LPO), always bilateral for comparison

What is the film size for AP Oblique Lumbar Spine?

14x17 LW

How is the patient positioned for AP Oblique Lumbar Spine?

From supine, rotate approx 45° toward side of interest, flex elevated knee, extend opposite leg, arm across chest

How is the part positioned for AP Oblique Lumbar Spine?

Rotate patient into RPO/LPO, place support under elevated side to maintain position

Where is the central ray directed for AP Oblique Lumbar Spine?

90° entering 2" medial to elevated ASIS, 1.5" above iliac crest (L3) on 11x14; directly at iliac crest (L4) on 14x17

What anatomy is demonstrated on 45° AP Oblique Lumbar Spine?

Upper zygapophyseal joints (L1–L4) on side down (open), “Scotty dogs,” pedicles centered in vertebral bodies

What anatomy is demonstrated on 30° AP Oblique Lumbar Spine?

L5-S1 zygapophyseal joint (Kovacs)

What is the projection for Lateral Lumbar Spine on this page?

Lateral LS

What is the film size for Lateral Lumbar Spine?

11x14 LW or 14x17 LW

How is the patient positioned for Lateral Lumbar Spine?

Left lateral recumbent, arms at 90° or across chest, knees flexed and directly superimposed

How is the part positioned for Lateral Lumbar Spine?

Hips and shoulders aligned; if lumbar sag present, place sponge under patient to straighten spine

Where is the central ray directed for Lateral Lumbar Spine?

90° entering mid-coronal plane at level: 1.5" above iliac crest (L3) for 14x17; iliac crest (L4) for 11x14

What anatomy is demonstrated on Lateral Lumbar Spine?

L1–L5 bodies, intervertebral foramina, pedicles, spinous processes, intervertebral disk spaces

What is the projection listed on this page?

L5-S1 “Spot” Lateral

What is the film size for L5-S1 Spot Lateral?

8x10 LW or 10x12 to include coccyx

How is the patient positioned for L5-S1 Spot Lateral?

Patient in left lateral recumbent position with body and elbows flexed; flex knees and superimpose

How is the part positioned for L5-S1 Spot Lateral?

Hips and shoulders in the same plane; if lumbar sag is present place sponge under patient to straighten spine

Where is the central ray directed for L5-S1 Spot Lateral?

90° when spine is parallel to IR; when spine is not parallel, angle 5° caudad for males and 8° caudad for females; CR enters L5-S1 (L4) & ASIS (S2) on a coronal plane 2" posterior to ASIS

What anatomy is demonstrated on L5-S1 Spot Lateral?

Open lumbosacral joint, body of L5, sacrum, superimposed ilia

What projections are included in Optional Lumbosacral Spine?

PA Oblique LS Spine (RAO & LAO), always bilateral for comparison

What film sizes are listed for PA Oblique LS Spine?

11x14 LW or 14x17 LW

How is the patient positioned for PA Oblique LS Spine?

From prone position turn patient into semiprone position, support elevated side on flexed knee and forearm

How is the part positioned for PA Oblique LS Spine?

Oblique patient 45° to demonstrate L1-L4 zygapophyseal joints or 30° to demonstrate L5-S1 zygapophyseal joint

Where is the central ray directed for PA Oblique LS Spine?

90° entering 2" lateral from the spine toward elevated side at level: 1.5" above iliac crest (L3) on 11x14; directly at iliac crest (L4) on 14x17

What anatomy is demonstrated on 45° PA Oblique LS Spine?

Upper 4 zygapophyseal joints of side up (open), appearance of Scotty Dogs, pedicles centered in vertebral bodies

What anatomy is demonstrated on 30° PA Oblique LS Spine?

L5-S1 zygapophyseal joint (Kovacs)

What is the film size for PA Weight-Bearing Lumbar Spine (Left & Right Bending)?

14x17 LW

How is the patient positioned for PA Weight-Bearing Lumbar Spine?

Patient erect, pelvis straight, facing vertical grid with arms at sides

How is the part positioned for PA Weight-Bearing Lumbar Spine?

With MSP centered to grid patient leans laterally as far as possible to right and left

Where is the central ray directed for PA Weight-Bearing Lumbar Spine?

90° to MSP at level of L3

What anatomy is demonstrated on PA Weight-Bearing Lumbar Spine?

Degree of mobility of intervertebral joints for lower T-spine and LS spine