![]() SCIWORA syndrome occurs when the elastic ligaments of a child's neck stretch during trauma. This situation has been named “SCIWORA” ( spinal cord injury with out radiographic abnormality) syndrome. In children, it is not uncommon for a spinal cord injury to show no radiographic abnormalities. Unilateral facet dislocations ( Figure 5)Īnterior dislocation of 25 to 33% of one cervical vertebra on lateral views an abrupt transition in rotation so that lateral view of affected vertebra is rotated lateral displacement of spinous process on anteroposterior viewįlexion, such as when picking up and throwing heavy loads (such as snow or clay)Īvulsion of posterior aspect of spinous process frequently an incidental findingĪ special situation involving children deserves mention. Large wedge off the anterior aspect of affected vertebra ligamentous instability causes alignment abnormalitiesĪnterior displacement of 50% or more of one cervical vertebra on lateral views Occurs with sudden deceleration (hanging) and with hyperextension, as in motor vehicle accidentsīilateral pedicle fracture of C2 with or without anterior subluxation lateral view required May be difficult to see on plain films high clinical suspicion requires CT scanning Occurs in patients with Down syndrome, rheumatoid arthritis and other destructive processesĪsymmetric lateral bodies on odontoid view, increased predental space Once an injury to the spinal cord is diagnosed, methylprednisolone should be administered as soon as possible in an attempt to limit neurologic injury.īurst fracture occurs with axial load or vertebral compressionĭisplaced lateral aspects of C1 on odontoid view, predental space more than 3 mm The “SCIWORA” syndrome (spinal cord injury without radiographic abnormality) is common in children. The most common reason for a missed cervical spine injury is a cervical spine radiographic series that is technically inadequate. The lateral view must include all seven cervical vertebrae as well as the C7-T1 interspace, allowing visualization of the alignment of C7 and T1. Views required to radiographically exclude a cervical spine fracture include a posteroanterior view, a lateral view and an odontoid view. The related article that I've included on this page is about cervical radiographic projections and Matt has created a series of great illustrations to accompany these, so I would certainly recommend checking them out if you are interested.Significant cervical spine injury is very unlikely in a case of trauma if the patient has normal mental status (including no drug or alcohol use) and no neck pain, no tenderness on neck palpation, no neurologic signs or symptoms referable to the neck (such as numbness or weakness in the extremities), no other distracting injury and no history of loss of consciousness. I particularly like the section where he points out the differences between the T1 transverse process and the C7 transverse process, and the idea of the articular pillar having a sinusoidal margin on the frontal projection, which becomes really handy to know later in this learning pathway when he discusses facet joint degeneration. The anatomy that Matt chooses to focus on is particularly useful from an interpretation perspective, like appreciating the normal anteroinferior margin of the vertebral body on the lateral projection and the normal airway outline on the AP projection. He assumes a basic level of existing anatomy knowledge, so I've created some additional annotated images for you to scroll through to supplement this. Matt begins his lecture by running through some normal cervical spine radiographic anatomy. Report problem MENU NEXT Audio transcript demonstrated the intervertebral foramina of the side positioned closer to the image receptor.demonstrates the intervertebral foramina of the side positioned further from the image receptor.also known as a 'peg' projection it demonstrates the C1 (atlas) and C2 (axis).anterior-posterior relationship of the vertebral bodies.soft tissue structures around the c spine. ![]() anteroposterior projection of the cervical spine demonstrating the vertebral bodies and intervertebral spaces.Note: in the absence of CT 5 views of the C-spine should be performed: AP, lateral, obliques and odontoid 5. IndicationsĬervical spine radiographs are indicated for a variety of settings including 1-3:Ī decision to pursue C-spine imaging of any kind should be cross-referenced with the 'Canadian C-Spine Rule' for C-spine imaging due to its high sensitivity and specificity 4. The cervical spine series is a set of radiographs taken to investigate the bony structures of the cervical spine, albeit commonly replaced by the CT, the cervical spine series is an essential trauma radiograph for all radiographers to understand.
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