In addition, 88% of the radiographers believed that the weight-bearing position could increase the visibility of the C-spine. While 54% of the radiographers utilized two water-filled cans during the weight-bearing technique, 82% used holding arms back with the shoulders down and pulling as low as possible in the non-weight-bearing technique. Most of them employed the standing breath-holding technique for image acquisition with or without exertion. Results: The radiographers used weight-bearing and non-weight-bearing positioning techniques for the erect lateral C-spine radiography. Methods: This prospective study was conducted with a self-administered, structured questionnaire distributed among 50 radiographers working in four selected hospitals in Sri Lanka. This study explores the current practice and perception of radiographers on positioning techniques of erect lateral cervical spine radiography in non-trauma adult patients.
Therefore, the radiographers have adapted different positioning strategies to overcome this challenge. The management of patients with cervical spine trauma in the absence of obvious osseous injury on standard radiographs should warrant a computed tomography (CT) scan if clinically indicated.Ĭervical spine fractures Cervical spine injuries Lateral cervical spine radiographs Soft tissue measurements.Background: The visualization of the lower cervical spine (C-spine), including the C7-T1 junction on lateral radiograph is a challenge due to the overlapping of the shoulder girdle. They, therefore, do not offer any further value in interpreting traumatic cervical spine radiographs. Both commonly used measures of soft tissue shadows in clinical practice are insensitive in identifying patients with significant osseous injuries. There is no significant difference between the soft tissue shadows when comparing patients with and without cervical spine fractures on lateral radiographs. The sensitivity and specificity for method 1 was 7.6 and 93 %, and for method 2, they were 7.6 and 98 %, respectively. Both methods failed to identify any significant differences between the two groups. Thirty-nine patients in group 1 were compared to a control group of 60 patients in group 2. The prevertebral soft tissue shadows were measured at referenced points on the lateral cervical spine films with respect to the above two methods and comparisons between the groups were made. Patients were divided into two groups: group 1-fractures group 2-no fractures. To assess which of the above two methods in assessing cervical spine soft tissue shadows on lateral radiographs is more sensitive in the presence of cervical spine injuries.Ī retrospective analysis of consecutive traumatic cervical spine films performed within a busy trauma tertiary centre over a period of 7 months. The two more commonly used techniques include the 'seven at two and two at seven' rule (method 1) and the ratio of the soft tissues with respect to the vertebral width (method 2).
Many methods are used to assess the prevertebral soft tissue shadows. They can provide information on subtle injuries that may not be obvious. Soft tissue assessment forms an integral component of these radiographs. Lateral plain radiographs remain the primary investigation in the assessment of these injuries. Traumatic neck pain is a common presentation to the emergency department.