MODULE 2 Cervical Spine

Normal Anatomy: typical and atypical features Extraspinal points of assessment Sella turcica - maximum 16 X 12, double floor sign, any erosion Lung apices paravertebral calcification - carotid bifurcation Can’t see vertebral artery calcification

Series Minimum - three (APOM, APLC, Lateral) Standard - five (APOM, APLC, Lateral, Right/Left Obliques with radiating signs and symptoms) Alternative - (APOM, APLC, Lateral, Flexion/Extension to document motion and stability) Standard - seven (Trauma series, 9 views)

Most underutilized study is the Pillar view Most common cervical spine fracture is facets 17% cervical fracture at C7 6/10 fractures found 2.4 fractures are the average You see a cervical spine fracture, stabilize and transport. Stop the series.

Lines of Mensuration ADI Decrease degenerative joint disease Increase trauma occipitalization Down’s Syndrome 20% born without transverse ligament 25% have small posterior arch

Lines of Mensuration Continued Pharyngeal infection Ankylosing spondylitis Rheumatoid arthritis Psoriasis Reiter’s

Lines of Mensuration Continued George’s Line Posterior Cervical Line (spinolaminar joint line) Sagittal diameter, not useful Atlanto-axial alignment C1 fracture Cervical spine gravity line