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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