Cervical spine (lateral view)

Cervical spine lateral view is a lateral projection of the cervical spine.It is often performed in the setting of trauma.

As technology advances, computed tomography has replaced this projection, yet there remain many institutions (especially in rural areas) where computed tomography is not readily available.

Patient position

• the patient is supine or erect, depending on trauma or follow up  
• the detector is placed landscapeportrait, running parallel to the long axis of the cervical spine on the patients left the side 
• instruct the patient the image will be taken on suspended expiration 

Technical factors

• lateral projection
• centring point
  • 2.5 cm above the jugular notch at the level of T1
• collimation
  • superior to C1
  • inferior to T1
  • anterior to include soft tissue
  • posterior to the soft tissue
• orientation
  • portrait 
• detector size
  • 24 cm x 30 cm
• exposure
  • 50-75 kVp
  • 20-50 mAs
• SID
  • 150-180 cm
• grid
  • yes

Image technical evaluation

• there should be a clear visualisation of C7 to T1
• the vertebral bodies are superimposed laterally
• the articular pillars and zygapophyseal joints are superimposed

Practical points

Traction

• this projection may require inferior traction of the arms to better visualise T1, this is performed by a qualified individual. Points to keep in mind whilst traction is being applied:
  • full expiration is best for optimal inferior displacement of the shoulders to visualise T1 
  • clear communication between yourself and the one performing traction is a must, ensure they are clear when traction is being applied as to avoid motion artefact 
  • ensure individual applying traction is in a lead gown
• if T1 cannot be visualised a swimmer's lateral projection may be required