X-rays of the cervical spine: what shows functional tests
X – ray is available for all categories of the population the diagnostic method that shows the structure of bones and helps to identify developmental abnormalities, degenerative changes. Indispensable for injuries allows you to quickly assess the nature of the damage. Radiography of the cervical spine is the leading method for the study of the pathology of this region. Of course, with the advent of CT and MRI, it cannot be considered as the most informative. However x-ray remains popular in the initial phase of diagnosis.
However, the study of structures not from bone – intervertebral discs, ligaments, muscles, the spinal cord — it is necessary to resort to additional methods. Neck x-ray shows only the vertebrae, the condition of the other anatomical structures can be judged only by circumstantial evidence. There is, of course, the study with the introduction of radiopaque substances under the arachnoid (myelography), allowing to see on an x-ray of the spinal cord. However, this method is currently being replaced by more safe and informative CT and MRI.
X-rays of the neck allows you to detect traumatic damage to the vertebrae, malformations, tumours and pathology of the intervertebral discs (eg, osteochondrosis). Therefore, the indications for this type of research are:
- A suspected neck injury.
- Violation of the mobility or the deformation (curvature) of the cervical spine.
- Pain in the neck.
- Signs of a lesion of the cervical spine, which arose on the background of some infectious diseases (eg, tuberculosis).
- Headache, dizziness, especially appearing when bending and turning the head.
- Pain in the upper extremities, the cause of which could not be identified (it may occur with cervical osteochondrosis).
The C-spine has almost no contraindications. The only exception is pregnancy, however, in case of emergency (e.g., spinal injury) this study is performed using the measures of protection of the fetus from the radiation. Child x-ray neck can be done with the first days of life. Special training research is not required. Is free of charge in the clinic at the place of residence or paid in private diagnostic centers.
When x-rays of the cervical spine radiation dose equal to 0.2 or 0.03 mSv for film or digital radiography, respectively.
As the picture is taken?
- Video. The patient is standing or lying down, arms along the body, the mouth is closed. The line from the occlusal surfaces of the teeth to the apex of the mastoid process is perpendicular to the cassette. The x-ray beam is directed at an angle of 15-20° to the thyroid cartilage and passes parallel to the line from the lower jaw to the tip of the mastoid (skull base).
This projection allows you to see the spine from the III cervical vertebra. The bones of the skull base and lower jaw is closed upstream of the structure. To view them, additionally it is the through the open mouth. The patient while lying or standing. Line from the lower edge of the upper incisors to the base of the skull is directed perpendicular to the cassette. The x-ray beam passes through the center of the mouth. Direction relative to the cassette perpendicular.
Consider performing radiography of the cervical vertebrae in two basic projections:
- Side. Is performed when the patient is vertical (standing or sitting) and horizontally (lying on back). Shoulder pressed to the tape, a few chin pushed forward. The x-ray beam is directed at the IV cervical vertebra and is perpendicular to the cassette.
Conditions for obtaining a high quality photo:
- All jewelry and other items from the patient’s neck lifted.
- The patient stationary during the execution of the picture, not breathing and does not make swallowing movements.
If x-rays of the neck are assigned a small child, you may need the help of the parents to hold the patient in a fixed position. The through the mouth to comply, most likely, will not work.
What the study shows?
X-rays of the neck allows you to judge the condition of the vertebrae and intervertebral discs:
- Trauma of the spine. On the x-ray you can see the fissures in the bodies and processes of the vertebrae, the displacement of bone fragments and vertebrae themselves. The compression fracture observed wedge-shaped deformation of the vertebral body and reduction of its height.
- Bone torticollis. Due to pathology of the cervical vertebrae. Can be congenital (malformation – a wedge-shaped vertebra) or acquired as a result of injury. X-rays of the cervical spine helps to identify the disease and make a differential diagnosis with other variants of torticollis: spasmodic, hypoplastic, dermatogenic.
- Malformations. On the x-ray you can see the change in shape of the vertebrae, hypoplasia of the arches and processes, the emergence of additional vertebrae, cervical ribs.
- The tumor on the x-ray visible if directly localized in bone structures. Foci of destruction in the vertebrae could mean a primary cancer or metastases. Spinal cord tumor, has not led to the destruction of the vertebrae, can be seen on x-rays while injecting a contrast agent, that is, when performing myelography.
- Spondylolisthesis. Radiographic signs of pathology is displacement of one vertebra relative to the adjacent forward or to the side.
- Osteochondrosis is characterized by a decrease in the height of the intervertebral gap and the appearance of osteophytes — bony growths, destruction zamechatelnyh plates of the vertebral bodies. When x-rays with functional tests can detect the displacement of the vertebrae, which indicates the instability of disks.
X-ray of the spine reveals a wide range of diseases of the vertebrae and intervertebral discs. However, in some cases to clarify the diagnosis may require more modern methods – CT or MRI.
Other methods of studies of the cervical spine
Myelography and pneumonologia – variant of x-ray using contrast. In the first case, a water-soluble iodine-containing substance, the second air. Currently, methods are not needed because CT and MRI allow to obtain the same information without resorting to the procedure of injection of the contrast into the subarachnoid space.
The best alternative, exceeding the capabilities of x-ray is CT or MRI. These methods allow you to see not only bone, but also magadane education, including structures located in the spinal canal. The last visualization when performing CT is worse than MRI, and requires to enhance the information content of administration of contrast (CT myelography). MRI-myelography allows you to see the spinal cord without the introduction of special preparations.