ISSN 2398-2942      

Radiography: spine

icanis

Introduction

  • Great care must be taken when handling and positioning a patient with a possible instability of the spine.
    An initial lateral survey film (without undue manipulation of the patient), may be appropriate.
  • Higher quality images can be obtained following an initial assessment of the extent of the problem.
  • Successful radiography of the spine requires strict attention to the details of positioning.
  • In the cervical region, satisfactory positioning is usually not possible without a general anesthetic.
  • To achieve accurate positioning it is necessary to consider the whole patient, rather than focussing only on the area of interest.
  • It is important to remember to avoid rotation of the spine in the craniocaudal direction, as well as the ventrodorsal direction.
  • Radiography of a large number of vertebrae on one film is to be avoided, as the oblique rays towards the periphery of the beam will not pass through the disk spaces, with the result that spaces may appear artefactually narrowed.
  • In judging whether a patient is positioned without rotation it is worth bringing eye level down to patient level. Pinpoint landmarks, such as sternum/spinous processes, with your fingers and then check that the fingers are in the same plane.
  • Accurate centring and collimation in the spine depends more on experience than radiography of most other areas of the body. With practice, it becomes possible to pinpoint features which do not benefit from easily palpable localizing landmarks.
  • Liberal use of foam pads is helpful.
    A secondary radiation grid should be used for patients >10 cm in thickness.
  • The objective is to produce radiographs showing the area of interest without rotation of the vertebrae or artificial narrowing of the disk spaces.
  • The film must be correctly exposed and processed and show the anatomical marker, the patient's identification, the date, and the name of the hospital or practice.

Uses

Advantages

  • Non-invasive although may require GA.

Disadvantages

  • Often requires myelography to define a soft tissue lesion and confirm spinal cord compression.

Requirements

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Preparation

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Procedure

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Galloway A M, Curtis N C, Sommerlad S F et al (1999) Correlative imaging findings in seven dogs and one cat with spinal arachnoid cysts. Vet Radiol Ultrasound 40 (5), 445-452 PubMed.
  • Morgan J P (1999) Transitional lumbosacral vertebral anomaly in the dog - a radiographic study. JSAP 40 (4), 167-176 PubMed.
  • Penderis J, Sullivan M, Schwarz T et al (1990) Subdural injection of contrast medium as a complication of myelography. JSAP 40 (4), 173-176 PubMed.

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