Cervical Vertebrae Study

AP Axial Projection

1. Patient in upright or supine position;
2. Extend the chin slightly;

Central ray angled 15º-20º cephalad to C4.

Respiration:Suspended.

Evaluation Criteria:

• Disk spaces open;
• No rotation;
• Spinous process equidistant to the pedicles;
• Visualization of C3 to T1 in the center of the image;
• Superimposed of the mandible and occiput over the atlas and axis;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

Lateral Projection

1. Patient in upright or seated position;
2. Place in a true lateral position;
3. Elevate the chin slightly.

Central ray perpendicular and horizontal to C4.

Respiration: Suspended at the end of the expiration.

Evaluation Criteria:

• Visualization of the all seven cervical vertebrae and T1;
• No overlapping of mandible to the atlas or axis;
• Spine in the center of the image;
• No rotation: zygapophysical joints overlapped;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

Lateral Projection- Hyperflexion and hyperextension

1. Patient in a true lateral position;

• Hyperflexion: Draw the chin as much as possible to the chest;
• Hyperextension: Elevate the chin as much as possible.

Central ray perpendicular and horizontal to C4

Respiration: Suspended.   

     Hiperflexion

Hiperextension

Evaluation Criteria:

• No rotation;
• Cervical vertebrae in profile position;
• Visualization of C1 to C7;
• In Hyperflexion the body of mandible it is almost in vertical position;
• In Hyperextension the body of mandible it is almost in horizontal position;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

Hiperflexion

Hiperextension

AP Axial Projection

1. Patient in upright position;
2. Body rotation at 45º.

Central ray angled 15-20º cephalad to C4.

Respiration: Suspended.

Evaluation Criteria:

• Visualization of C1 to T1;
• Intervertebral foramina open;
• Disk spaces open;
• Occipital and mandible not overlapping to the atlas or axis;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).