Anatomy Demonstrated; C3 to T2 vertebral bodies; space between pedicles and intervertebral disk spaces clearly seen. 

Patient Positioning; Position patient in the supine or erect position with their arms by their sides. Align MSP to CR and midline of table or Ir. Adjust the patients head so that a line from the lower margin of the upper incisors to the base of the skull is perpendicular to the table and/or IR. The line from the tip of the mandible to the base of the skull should be parallel to angled CR. 

IR: 8x10 or 10x12- portrait orientation.

SID: 40 inches. Four-sided collimation.

CR: Angle CR 15-20 degrees cephalad. Direct CR to enter at the level of the upper margin of the thyroid cartilage to pass through C4.  angle the CR 15 degrees when the patient is supine or if there is less lordotic curvature. Angle the CR 20 degrees when the patient is erect or when more lordotic curvature is evident.

Clinical Indications: Pathology involving the mid and lower cervical spine. Demonstrates clay shoveler's fracture, compression fractures, HVP, and degenerative disease.  

-Ali Keller

Anatomy Demonstrated: Intervertebral foramina and pedicles on the side of the side of the patient closest to the IR (left). Intervertebral disk spaces and IVF of C2 through C7 should be open and uniform in size and shape. The pedicles are demonstrated in full profile. 

Patient Positioning: The erect position is preferred, but recumbent is possible is the patient's condition requires. Align the MSP to the CR and midline of the table. Place patients' arms at their sides. Rotate head and body into a 45-degree oblique position. Protract chin to prevent mandible from super imposing vertebrae. Elevate the chin to place AML parallel with the floor. 

IR: 10x12-Portrait

SID: 40-72 inches. Longer SID recommended. Four-sided collimation. 

CR: Direct CR 15-20 degrees caudad to C4 or the upper margin of the thyroid cartilage. 

Clinical indications: Pathology involving the cervical spine and adjacent soft tissue structures, including stenosis involving the intervertebral foramen. Both right and left oblique positions should be taken for comparison purposes. 

Anterior positions are preferred because of reduced thyroid dose.

-Ali Keller 

Anatomy Demonstrated; Intervertebral foramina and pedicles on the side of the patient farthest from the IR (left). Left and right pedicles respectively. Intervertebral disk spaces and intervertebral foramina of interest (C2 through C7 should be open and uniform in size and shape. The pedicles of interest should be demonstrated in full profile and the opposite, on end pedicles should be aligned along the anterior cervical body.

Patient Positioning; The erect position preferred (sitting or standing) but recumbent is possible if the patient's condition requires. Align the MSP to CR and midline of table. Place patient's arms at side; if patient is recumbent, place arms as needed to help maintain position. Rotate body and head into a 45 degree oblique position. Protract chin to prevent mandible from superimposing vertebrae.

IR: 10x12- portrait.

SID: 40-72 inch SID, longer SID is recommended. Four-sided collimation.

CR: Direct 15-20 degrees cephalic to C4 and to the center of the IR. 

Clinical indications: Pathology involving the cervical spine and adjacent soft tissue structures, including stenosis involving the intervertebral foramen. Both left and right oblique projections should be taken for comparison purposes.

-Ali Keller

Anatomy Demonstrated; Intervertebral foramina and pedicles on the side of the patient farthest from the IR (right). Intervertebral disk spaces and intervertebral foramina of interest (C2 through C7) should be open and uniform in size and shape. The pedicles of interest should be demonstrated in full profile and the opposite on end pedicles should be aligned along the anterior cervical body. 

Patient Positioning: The erect position is preferred but recumbent is possible if the patient's condition requires. align the SP to the CR and the midline of the table. Place patients' arms at their sides. Rotate the body and head into a 45-degree oblique position. Protract chin to prevent mandible from superimposing vertebrae. Elevate chin to place AML parallel with floor. 

IR: 10x12- portrait.   

SID: 40-72 inches. longer SID is recommended. Four-sided collimation.

CR: Direct CR 15-20 degrees cephalad to C4. Direct the center of the IR to CR. 

Clinical indications: Pathology involving the cervical spine and adjacent soft tissue structures, including stenosis involving the intervertebral foramen. Both left and right oblique projections should be taken for comparison purposes. 

-Ali Keller

Anatomy Demonstrated: Intervertebral foramina and pedicles on the side of the side of the patient closest to the IR (right). Intervertebral disk spaces and IVF of C2 through C7 should be open and uniform in size and shape. The pedicles are demonstrated in full profile. 

Patient Positioning: The erect position is preferred, but recumbent is possible is the patient's condition requires. Align the MSP to the CR and midline of the table. Place patients' arms at their sides. Rotate head and body into a 45-degree oblique position. Protract chin to prevent mandible from super imposing vertebrae. Elevate the chin to place AML parallel with the floor. 

IR: 10x12-Portrait

SID: 40-72 inches. Longer SID recommended. Four-sided collimation. 

CR: Direct CR 15-20 degrees caudad to C4 or the upper margin of the thyroid cartilage. 

Clinical indications: Pathology involving the cervical spine and adjacent soft tissue structures, including stenosis involving the intervertebral foramen. Both right and left oblique positions should be taken for comparison purposes. 

Anterior positions are preferred because of reduced thyroid dose. 

-Ali Keller

Anatomy Demonstrated; Odontoid process (dens) and vertebral body of C2, lateral masses and transverse processes of C1, and atlantoaxial joints seen through the open mouth.

Patient Positioning; The patient should have optimal flexion/extension of the neck indicated by the base of the skull. Neither the teeth nor the skull base should superimpose the dens. If teeth are superimposed on the upper dens, reposition by slight hyperextension of the neck or angle the CR cephalically. If the base of the skull is superimposed on the upper dens, reposition by slight hyperflexion of the neck or angle the CR slightly caudal.

IR: 18x24 (Portrait) 

SID: 40"

CR: Perpendicular to IR, direct CR through open mouth 

Clinical indications: Pathology (particularly fractures) involving C1 and C2 and adjacent soft tissue structures, demonstrates Odontoid and Jefferson fractures 

-Ashley Fallert

-Ali Keller

Anatomy Demonstrated; Cervical vertebral bodies, intervertebral joint spaces, articular pillars, spinous process, and zygapophyseal joints. C1-T1 intervertebral joint spaces are clearly demonstrated. The rami of the mandible do not superimpose C1 to C2. The right and left articular pillars and zygapophyseal joints should be superimposed for each vertebra. The bodies should be free of superimposition of the articular pillars and the spinous process seen in profile.

Patient Positioning; Position patient in the erect or lateral position, either sitting or standing, with shoulder against vertical IR.

IR: 10x12 (Portrait)

SID: 60"- 72"

CR: Perpendicular to IR to C4 (level of upper margin of thyroid cartilage

Clinical indications: Pathology involving the cervical spine and adjacent soft tissue structures, degenerative diseases including Spondylosis and osteoarthritis.

-Ashley Fallert