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Cross-Table Lateral C-Spine
Aka: Cross-Table Lateral C-Spine, Lateral Cervical Spine XRay, Lateral C-Spine XRay
- See Also
- C-Spine XRay
- Open Mouth Odontoid
- Indications
- Cervical Spine XRay in Acute Traumatic Injury
- Evaluation: General (Mnemonic: ABCDS)
- Adequate film and Alignment
- Bony landmarks
- Cartilaginous space and curvature
- Discs
- Soft tissue spaces
- Evaluation: Adequate film criteria
- Visualize all seven Vertebrae (including C7-T1)
- Major pitfall: Inadequate visualization of the entire Cervical Spine from C1 to the top of T1
- C7-T1 is a common site of Cervical Spine Injury (visualization is critical)
- Maneuvers to enhance view of lower C-Spine C7-T1
- Pull down on arms during cross-table lateral
- Swimmer's View
- Cervical Spine CT
- Evaluation: Alignment
- Assessment criteria
- Landmarks should line up with <3mm discrepancy
- Landmarks
- Anterior Vertebrae
- Posterior Vertebrae
- Facets
- Spinous process (Spinolaminar line)
- Middle of anterior spinous process lines up C1-C3
- Normal variants: Pseudosubluxation of C2 and C3
- Normal in children
- Seen in 20% of children under age 8 years
- Abnormal findings
- Subluxation of >=3 mm is abnormal
- Angulation >11 degrees is unstable
- Evaluation: Bony landmarks
- Trace unbroken outline of each Vertebrae
- Trace odontoid outline from C2 Vertebrae
- Evaluation: Cartilaginous space
- Predental space (atlanto-dens interval)
- Distance from dens to C1 body
- Normal values
- Adult: 3mm
- Child: 5mm
- Evaluation: Discs
- Assess symmetry of disc spaces
- Observe for avulsion Fractures off the Vertebral bodies
- Superior avulsion Fractures are stable
- Inferior avulsion Fractures are unstable
- Evaluation: Soft Tissue spaces
- Normal Fat tissue stripe <3 mm
- Maximum normal width of soft tissue stripe (Mnemonic: 6 at 2 and 22 at 6)
- Normal C2 stripe: 6-7 mm
- Normal C5-6 stripe: 22 mm (approximately Vertebral width)