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Cervical Spine Radiography: Assessment and Imaging with X-Ray, CT, and MRI
Mark P. Bowes, PhD
*Medical Writer, Portland, Oregon.
Address correspondence to: Mark P. Bowes, PhD, Medical Writer, 7135 SE 18th Avenue, Portland, OR 97202. E-mail: email@example.com.
Disclosure Statement: Dr Bowes reports having no financial or advisory relationships with corporate organizations related to this activity.
Each year, at least 1 million people with possible blunt trauma of the cervical spine are seen in emergency departments in the United States. The goal of the radiographic evaluation of the spine is to identify or exclude anatomic abnormalities or disease processes while using the minimum radioactivity exposure needed to produce a diagnostic study. Over the last decade, suspected spine injuries have increasingly been evaluated using multidetector computed tomography (CT) rather than plain radiography. Cervical spine radiography is used primarily when CT is not immediately available or for specialized imaging applications, including suboptimal CT reconstruction or motion artifacts, treatment planning, or for children age 14 or younger. Only about 1% to 5% of patients with blunt trauma have cervical spine fractures or dislocations, and clinical decision rules have been developed to identify individuals who may be safely cleared of cervical spine injury without imaging. Two sets of clinical decision rules—the National Emergency X-Radiography Utilization Study rules and the Canadian C-Spine Rules—are widely used to evaluate the risk of cervical spine injury on the basis of factors such as patient age, level of alertness, or type of injury. For patients with suspected cervical spine injuries who require imaging, radiography provides valuable information about a range of cervical spine structures, including the vertebral bodies, disk spaces, joints, and associated soft tissues. Appropriate technique is essential to ensure the acquisition of diagnostic images and patient safety. This article provides an overview of the radiographic assessment of the cervical spine, with particular emphasis on cervical spine imaging in patients with blunt trauma.
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