Felis ISSN 2398-2950

Radiography: spine

Contributor(s): Patsy Whelehan

Introduction

  • Great care must be taken when handling and positioning a patient with a possible instability of the spine.
    An initial lateral survey film without undue manipulation of the patient may be appropriate.
  • Higher quality images can be obtained following initial assessment of the extent of the problem.
  • Successful radiography of the spine requires strict attention to the details of positioning.
  • In the cervical region, satisfactory positioning is usually not possible without a general anesthetic.
  • To achieve accurate positioning it is necessary to consider the whole patient, rather than focusing only on the area of interest.
  • It is important to remember to avoid rotation of the spine in the craniocaudal direction, as well as the ventrodorsal direction.
  • Radiography of a large number of vertebrae on one film is to be avoided, as the oblique rays towards the periphery of the beam will not pass cleanly through the disc spaces, with the result that spaces may appear artifactually narrowed.
  • In spinal radiography of the cat (as opposed to the dog) it is less likely that the disc space width will be of major interest.
  • Generally it is acceptable to include longer expanses of the spine where a less specific survey is needed, but the collimation described is applicable to a detailed examination.
  • In judging whether a patient is positioned without rotation it is worth bringing eye level down to patient level. Pinpoint landmarks, (such as sternum and spinous processes), with your fingers and then check that the fingers are in the same plane.
  • Accurate centering and collimation in the spine depends more on experience than radiography of most other areas of the body. With practice it becomes possible to pinpoint features which do not benefit from easily palpable localizing landmarks.
  • Liberal use of foam pads is helpful.
  • The objective is to produce radiographs showing the area of interest without rotation of the vertebrae or artificial narrowing of the disc spaces.
  • The film must be correctly exposed and processed and show the anatomical marker, the patient's identification, the date and the name of the hospital or practice.

Uses

  • Fractures, with or without dislocation/spondylolisthesis  Spine: fracture T11-T12 - radiograph  Spine: T11-T12 disc - myelography .
  • Discospondylitis  Diskospondylitis.
  • Spinal deformities.
  • Vertebral neoplasia.
  • Spondylosis  Spine: spondylosis (thoracolumbar) - radiograph lateral (hypervitaminosis A Hypervitaminosis A  Bone: hypervitaminosis A - spine ).
  • Intervertebral disk prolapse/herniation (myelography often required for this).

Advantages

  • Non-invasive although often requires general anesthetic.

Disadvantages

  • May require myelography to define the lesion.

Requirements

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Preparation

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Procedure

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Galloway A M, Curtis N C, Sommerlad S F et al (1999) Correlative imaging findings in seven dogs and one cat with spinal arachnoid cysts. Vet Radiol Ultrasound 40 (5), 445-452 PubMed.


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