![]() ![]() Involves the posterior elements including the lamina, facet joints, spinous processes, and the associated ligaments.įigure 4. Involves the posterior aspect of the vertebral body/ intervertebral disc and the posterior longitudinal ligament. Involves the anterior two-thirds of the vertebral body/ intervertebral disc and the anterior longitudinal ligament. If spinal instability is suspected further imaging with CT or MRI should be considered. This states that if any 2 columns are injured then the injury is ‘unstable’. When describing and diagnosing spinal fractures, Radiologists divide the spinal column into 3 sections known as the ‘Three Column model’. Step 5Įnsure the vertebral and spinous processes are intact. Inspect the vertebral endplates: the continuity of superior and inferior endplates should remain uninterrupted. Note: the L5/S1 space is normally slightly narrower than L4/L5.In healthy individuals, the disc height should gradually increase from superior to inferior.Loss of vertebral height is suggestive of a fracture.The height of vertebral bodies should be equal in healthy individuals.Step 1Īssess alignment of the vertebral bodies and spinous processes including the lines discussed above and the distance between spinous processes. AP and lateral projections showing adequate alignment with yellow (spinous processes) and white (vertebral bodies) 2Ī structured approach to lumbar spine X-ray interpretation is essential. On the lateral view, check the alignment of the vertebral bodies.ĭisruption of any of these lines may indicate an underlying fracture.įigure 3B. On the AP/PA view check that the vertebral bodies and spinous processes are aligned. These lines should run uninterrupted in healthy individuals. There are multiple lines that should be assessed across each of the two typical radiographic views of the lumbar spine (AP/PA & lateral). AP projection of a normal lumbar spine highlighting the spinous processes (red) and transverse processes (green) 2 Patients with a suspected spinal injury must remain immobilised in the supine position. Spinal imaging should be taken erect in the non-trauma setting to give a functional overview of the lumbar spine. Transverse processes are often obscured by gas from the abdomen. The spinous processes (red) should be central and there should be equal distance between transverse processes (green). In an AP/PA view, the entire lumbar spine should be visible from T12 superiorly and the sacrum inferiorly. Lateral projection of a normal lumbar spine highlighting the vertebrae in yellow 2 Anterior-posterior (AP)/posterior-anterior (PA) ![]() Each vertebra (highlighted in yellow) should be examined looking for a loss of height which could indicate a compression fracture commonly associated with osteoporosis (see fractures section below).Ĭompression fractures are often seen in the upper lumbar or lower thoracic vertebrae. Lateral views are particularly useful for identifying fractures. In a lateral view, the entire lumbar spine should be visible from T12-S1. In the case of trauma, additional views can be sought including oblique and horizontal beam lateral views.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |