Show
Citation, DOI & article dataCitation: Nguyen M, Murphy A, Er A, et al. Cervical spine (AP oblique view). Reference article, Radiopaedia.org (Accessed on 01 Jan 2023) https://doi.org/10.53347/rID-51497 The AP oblique cervical spine projections are supplementary views to the standard AP, odontoid and lateral images in the cervical spine series and are always done bilaterally for comparison purposes. However, the PA oblique projection is preferred as it reduces radiation dose to the thyroid 1 compared to the AP oblique projection. On this page:This projection can be used to visualize pathology involving the adjacent soft tissue structures or cervical spine, especially stenosis of the intervertebral foramina. Note: Such views should not be performed on trauma patients without the strict instructions of a qualified clinician who has reviewed the lateral cervical spine image or CT of the cervical spine. Moving the patient's head or neck, or removing a cervical collar could be detrimental.
To demonstrate the intervertebral foramen of the c-spine open, it is necessary to achieve adequate rotation of the vertebral column, usually at 45°. If underrotated, the foramina will be narrowed and a sternoclavicular joint would be superimposed over the vertebral column 3. Over rotation of more than 45° would cause one pedicle to be foreshortened while the other pedicle aligns to the midline of the vertebral bodies 2. ReferencesRelated articles: Imaging in practicePromoted articles (advertising)June 19, 2003 -- This article is the 15th in our series of white papers on radiologic patient positioning techniques for x-ray examinations. If you'd like to comment on or contribute to this series, please e-mail .The standard radiographic examination for evaluating the lumbar spine includes the anteroposterior, lateral, and oblique projections, supplemented by coned-down lateral films of the lumbosacral junction (L5-S1). The anteroposterior (AP) view is usually sufficient for evaluating traumatic conditions involving vertebral bodies and transverse processes, and the intervertebral disk spaces are also well demonstrated, except for the lowest (L5-S1). The spinous processes and articular facets however are not well demonstrated on this projection. On the lateral projection of the lumbar spine, the vertebral bodies are seen in profile and the superior and inferior end plates are well demonstrated. Fractures of spinous processes are adequately evaluated on this projection, as are abnormalities involving the intervertebral disc spaces, including L5-S1. Oblique views are particularly effective in demonstrating the facet joints (articular facets). Examination of motion in the lumbar spine may provide useful information. To accomplish this, lateral radiographs may be obtained during flexion and extension, and frontal radiographs may be obtained during lateral bending of the spine. AP (or PA) projection of the lumbar-lumbosacral spine The frontal radiograph of the lumbar spine can be obtained in the posteroanterior (PA) or AP projection with the patient erect or recumbent. Although the AP projection is more commonly used, there are some advantages to the PA projection. Because the patient is in a prone position in the PA projection, the natural lumbar curvature is placed in such a way that the intervertebral disk spaces are parallel to the diverging beam of radiation, thus allowing better visualization of the intervertebral disc spaces. Moreover, the PA projection is more comfortable for patients who have back pain. An additional advantage is lower radiation dose for females (25%-30% less for a PA projection compared with AP projection). A disadvantage of the PA projection for a patient with a large abdomen is the increased object to image distance (OID) of the lumbar vertebra, which results in radiographic distortion. Technical factors
Positioning for the AP projection of the lumbar-lumbosacral spine
Evaluation criteria
Lateral projection of the lumbar-lumbosacral spine Technical factors
Positioning for lateral projection of the lumbar-lumbosacral spine
Evaluation criteria
Oblique projection of the lumbar-lumbosacral spine As in the cervical spine, an oblique projection of the lumbar spine can be obtained from either the patient’s anterior or posterior aspect, although the PA oblique projection is preferable. Oblique radiographs allow evaluation of the posterior elements of the lumbar spine (lamina, pedicle, the facet joints, and intervertebral foramina) although some regard the oblique projections as unnecessary. The L5 intervertebral foramina (right and left) are not usually well visualized on the lateral projection because of their oblique direction. Consequently, oblique projections are used for these foramina. When oblique projections are indicated, they are generally performed after the AP projection and in the same body position (recumbent or upright). For comparison, radiographs are generally obtained from both sides (right and left oblique). Technical factors
Positioning for oblique projections of the lumbar-lumbosacral spine
Evaluation criteria
AuntMinnie.com contributing writer June 19, 2003 Related Reading Radiographic positioning techniques for the cervical spine, March 26, 2003 Boning up on humerus, clavicle, and AC joint positioning, February 18, 2003 Getting the most from shoulder positioning, December 24, 2002 The bends and flexures of forearm and elbow x-ray positioning, November 21, 2002 The twists and turns of hand and wrist x-ray positioning, October 15, 2002 Copyright © 2003 AuntMinnie.com Which projection best demonstrates the intervertebral foramina?The posterior cervical oblique projections demonstrate the intervertebral foramina and pedicles on the side closest to the image receptor. An RPO position of the cervical spine requires a 45° oblique of the body with a 15° caudad CR angle.
Which of the following positions projections would best demonstrate the intervertebral spaces of the lumbar spine?Corectec. Which position projection is necessary to demonstrate the intervertebral foramina of the cervical spine?SJC Zerbe Procedures Semester 2 Unit 2. What shape is the vertebral foramen in the lumbar vertebrae?The foramen is triangular in shape for the cervical vertebrae. The thoracic vertebrae have a circular vertebral foramen. The lumbar vertebrae have triangular foramina. Together the vertebral foramina form the vertebral canal.
|