Spondylosis and degenerative changes in elderlyĬheck for evidence of hyperextension injury. Obtain an MRI for those with neurologic signs and symptoms.Ĭheck width of spinal canal for spinal stenosis. Where to look when you see nothing at all Two- or three-level fractures encountered in 20% of spinal fracturesĬT entire T and L spine after identifying fracture of C-spineįind a compression fracture: look for associated posterior element injury.įind a vertebral body injury: look for bony compromise of spinal canal.įind a facet malalignment on one side: look for contralateral facet malalignment/fracture. Where else to look when you see something obviousįind an injury at one level: closely evaluate the entire cervical spine above and below.įractures of C1 and C2 often associated with fractures of the lower cervical spine (C4-C7) Subtle fractures on radiography – need CT Relatively more involve lower cervical spine, C4-C7

Spinal cord injury without radiographic abnormality (SCIWORA)Īt and beyond 14 years of age injuries similar to those of adults Rare – apophyseal separations of synchondrosis between dens and body of C2 Relatively more involve upper cervical spine Often with either subtle or even without overt radiographic abnormality (SCIWORA)įracture of inferior or superior anterior margins of vertebral bodyįracture of osteophyte at superior or inferior anterior margin of vertebral bodyįractures in DISH (diffuse idiopathic skeletal hyperostosis)Ĭommon sites of injury in children and adolescentsĬervical spine injury ( CSI) rare in children under 8 years of age Spinal cord injury in presence of significant degenerative arthritis and disc disease Intervertebral disc, joint capsules, and interspinous ligamentĪnterior and posterior longitudinal ligamentsįacets – unilateral or bilateral – rotation, shearing injuries Vertical sagittal split of vertebral body Jefferson fracture – fractures of ring anterior and posteriorĬ2 pars interarticularis fractures – hangman’s fractureĬompression, distraction, and translation/rotation injuries (SLIC) Axial, sagittal, and coronal noncontrast images in bone algorithmĮxtending through at least the level of T1Īxial and sagittal images in soft tissue algorithmĬraniocervical junction (Skull base – C2)

Cervical spine x ray rules