Orthopaedic Jobs

Oblique View of C spine



- See: Pillar View

- Discussion:
    - demonstrates primarily neural foramina, pedicles, articular masses, apophyseal joints, & relative relationship at lamina;
    - oblique views show the pedicle in profile, and also allows assesment of the intervertebral foramina (and osteophytes encroaching 
          along their margins);

       

- Technique:
    - routine oblique views require rotating the patient's head and body;
    - may be obtained in AP or PA projections:
    - erect position is more comfortable;
    - entire position is rotated 45 deg to one side to avoid rotational differences among different vertebral segments;
    - central beam directed to C4 vertebra with 15-20 deg cephalic tilt;

- Trauma Oblique:
    - this view shows the pedicles and articualr processes well;
    - oblique views often are superior to any other view, including MRI or CT scans, for visualizing articular process frx & subluxations;
    - in difficult question of facet subluxation, flexed oblique views also can be obtained;
    - uncinate processes, pedicles, laminae, & inferior & superior articular facets are well seen using this technique;
    - C7-T1 relationship, which is frequently obscured on lateral film, may be seen on the oblique and obviate need for a swimmer's view;

- Technique Trauma Oblique:
    - trauma oblique series can be obtained without moving the head but by angling the tube 30-40 deg from the horizontal;
    - trauma oblique is obtained w/ x-ray beam 45 deg off vertical, patient supine, & ungridded cassette horizontal & located 
         towards opposite side of the patient;
    - this view shows pedicles & articular process well, although appearance of spine is slightly spread out;
    - major benefit of oblique view is that patient can remain supine;
    - no rotation of the torso or head is required;
    - furthermore, oblique views often are superior to any other technique, including CT or MRI scans, for visualizing articular process 
         fractures and subluxations;
    - in difficult questions of facet subluxations, flexed oblique views also can be obtained



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, August 25, 2011 1:53 pm