Lapis ISSN 2398-2969

Radiography: spine

Contributor(s): Lesa Thompson, Fraser McConnell

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 or restraint of the patient may be appropriate.

  • Higher quality images can be obtained following 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 focusing only on the area of interest.
  • It is important 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 cleanly through the disk spaces, with the result that spaces may appear artifactually narrowed.
  • In judging whether a patient is positioned without rotation it is worth bringing eye level down to patient level. Pinpoint landmarks, such as the sternum and spinous processes, with your fingers and then check that the fingers are in the same plane.
  • Accurate centering 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.
  • 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 an anatomical marker, the patient's identification, the date, and the name of the hospital or practice.

Print off the Owner factsheet on Xrays and ultrasound - why they help my vet  Xray and Ultrasound  to give to your clients.

  • The usual vertebral formula in rabbits is Ce7, T12, L7, S4, Cd15-16 - variations are common.

Uses

  • Indications:
  • Fractures, with or without dislocation   Spinal injury    Vertebra: thoracic fracture DV radiograph    Vertebra: thoracic fracture lateral radiograph  .
  • Spinal deformities, eg spondylosis   Spine: spondylosis deformans  .
  • Spinal abscesses.
  • Vertebral neoplasia.
  • Nutritional secondary hyperparathyroidism. Excess mineralization - osteosclerosis.
  • Intervertebral disk disease, discospondylitis.

Advantages

  • Non-invasive although often requires general anesthesia.

Disadvantages

  • May require myelography to define the lesion.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references fromPubMedandVetMedResource.
  • Gibbs C & Hinton M H (1981)Radiological examination of the rabbit. The head, thorax and vertebral column.JSAP22(11), 687-703PubMed.

Other sources of information

  • Hunt C (2013)Radiographic interpretation of the vertebral column.In:Manual of Rabbit Surgery, Dentistry and Imaging.Eds: Harcourt-Brown F & Chitty J. BSAVA, Gloucester. pp 76-83.
  • Rubel G A, Isenbugel E & Wolvekamp P (eds) (1991)Atlas of diagnostic radiology of exotic pets.W B Saunders Ltd, Philadelphia.


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