06 Spine

• AP VIEW OF THE CERVICAL SPINE

• TOWARDS C4 VERTEBRA (ADAM’S APPLE), 15-20 DEG CEPHALAD

view + central ray

name the ff structures

• LAT VIEW OF THE CERVICAL SPINE

• HORIZONTALLY TO THE CENTER OF THE C4 (LEVEL OF CHIN)

view + central ray

(TOP) BONE SPUR, (BOTTOM) NARROWING OF DISC

identify radiogaphic findings

TORG-PAVLOV RATIO

ratio of the spinal canal diameter to the vertebral body diameter

• OPEN OR ODONTOID “THROUGH-THE-MOUTH” VIEW

• THROUGH THE OPEN MOUTH, 15 DEG TILTED TOWARDS THE HEAD AT A DISTANCE OF 40 IN

view + central ray

OPEN OR ODONTOID “THROUGH-THE-MOUTH” VIEW

In this view, atlanto-axial joint are seen to be best advantage

• OBLIQUE VIEW

• THROUGH THE C4 VERTEBRA, BODY IS 45 DEG ROT AND THE TUBE IS AT 15 DEG

view + central ray

PILLAR VIEW

To evaluate the lateral masses of the cervical spin and facet joints

• PILLAR VIEW

• CENTER OF THE NECK AT THE THYROID CARTILAGE REGION, 30-45 DEG CAUDAL

PILLAR VIEW

On the radiograph obtained in this projection, the "lateral masses" (or what we call pillars of the cervical vertebrae) are well demonstrated

• OBLIQUE PILLAR VIEW

• HYPEREXT NECK, HEAD ROTATED 45 DEG TOWARDS UNAFFECTED SIDE

what view + position of pt

WEDGING

BAMBOO SPINE

SCOLIOSIS

NASH-MOE METHOD

Spinous process rotates to concavity

NEUTRAL

identify nash-moe grade

GRADE: +

pedicle disappearing

GRADE: ++

pedicle disappears

GRADE: +++

GRADE: ++++

COBB METHOD

RISSER-FERGUSSON METHOD

RISSER SIGN

RIB VERTEBRAL ANGLE DIFFERENCE

SPONDYLOLISTHESIS

One of the vertebrae slips forward; can happen anywhere along the spine but commonly occurs at the lower back

SPONDYLOLYSIS

Stress fx through the pars articularis of the lumbar vertebrae-a thin joint segment joining the two vertebrae-the most likely area affected by repetitive stress

SPONDYLOLYSIS

1. Transverse process

2. Pedicle

3. Superior articular process

4. Pars articularis/isthmus

5. Laminae

6. Inferior articular process

7. Spinous process

8. Interlaminar space

9. IV disc

findings + structures

SPONDYLOLYSIS

10. Scottie dog sign

findings + structures

SCOTTY DOG FRACTURE

defect at pars interarticularis

SCOTTY DOG FRACTURE

MEYERDING’S GRADING SYSTEM

This is a commonly adapted method of grading of spondyloptosis and it is based on the ratio of overhanging part of the superior vertebral body to the anteroposterior length of the adjacent inferior vertebral body.

GRADE 0 (NO SLIPPAGE)

identify grade

GRADE 1 (<25%)

identify grade

GRADE 2 (25-49%)

identify grade

GRADE 3 (50-75%)

identify grade

GRADE 4 (76-99%)

identify grade

GRADE 5

> 100% SPONDYLOPTOSIS

MEYERDING’S GRADING SYSTEM

LUMBARIZATION OF S1

SACRALIZATION OF L5

SACRALIZATION OF L5

Lumbosacral Transitional Vertebrae

TYPE 1 SACRALIZATION

a fusion of at least 19 millimeters in width of 1 or both sides

TYPE 2 SACRALIZATION

incomplete fusion with a pseudo joint created with 1 side or both sides

TYPE 3 SACRALIZATION

complete fusion at the L5 to the sacrum on one side or the other side

TYPE 4 SACRALIZATION

combination of type 2 and type 3

SPINA BIFIDA OCCULTA

Mildest type of Spina Bifida

SPINA BIFIDA OCCULTA

MENINGOCELE SPINA BIFIDA

When a sack that contains the spinal fluid, pushes through the gap in the spine

MYELOMENINGOCELE SPINA BIFIDA

When a sack that contains part of the spinal cord is covering and pushes through the spinal gap in the spine and in the skin; visible on the babies back

OSTEOPHYTES

are bone spurs that grow on any of the 7 vertebrae in the cervical spine; might elicit images of radiating spikes but bone spurs rounded end scalloped

WEDGING

This deformity occurs when the body of vertebra becomes fragmanted as in fracture crash or when the bone becomes sufficiently softened from pathologic processes, so that the body weight compresses the vertebra from above downwards

BAMBOO SPINE

occurs as a result of vertebral body fusion by margin syndesmophytes; often accompanied by fusion of posterior vertebral elements as well