Normal Radiographic Anatomy of the Spinal Column

Sarah Tibbs, BVetMed

Radiography of the Spine

Anatomy is complex z Many structures overlap complicating interpretation z Because of beam divergence the edges of film are effected by obliquity z Radiographic interpretation is compromised by poor positioning
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Radiography of the Spine

zProper

Positioning
patient positioning is CRITICAL positioning requires anesthesia, ties for the limbs and sponge wedges zIntervertebral disc spaces must be perpendicular to the table top (not oblique)
zProper z

z z z z z

Always take orthogonal views lateral and ventrodorsal (VD) Add oblique views if necessary Consider dynamic views (extended and flexed) in the cervical and lumbo-sacral regions Image each region separately, with the beam centered over the middle of that region Image certain areas with more collimation (i.e. caudal cervical, thoracolumbar, lumbo-sacral)

Vertebral column must z be parallel to the table top

The transverse process of the vertebrae should be perpendicular to the table

Vertebral Anatomy
z z

How to Count the Cervical Vertebrae z Landmarks

z z z

Example here is a cervical vertebra Think

z z z

Atlas C1 Axis C2 C6 with large transverse processes

Lamina as the roof Pedicles as the walls Body as the floor

Vertebral appearance varies somewhat by region, but basic parts are the same

2 3 4 5 6 7

How to Count the Thoracic Vertebrae

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How to Count the Lumbar Vertebrae

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Landmarks z T1 is actually just caudal to the first rib heads z T13 is the one with the last rib heads

Landmarks
z z

Use the sacrum to help you find L7 and then count backwards Or find T13 and count forwards
T12 T13

1
L1 L2 L3

4 5 6 7
Sacrum

C6 C7

3 4 5 6

10 8 9

11 12 13

General Spinal Anatomy

1. 2. 3. 4. 5.

General Spinal Anatomy

6.

7.

Body Vertebral endplates Lamina Spinous process Transverse processes Cranial articular process Caudal articular process

3 2

6 7

1
5

General Spinal Anatomy

Articular facet joint space Spinal canal
3. 1.

General Spinal Anatomy

Cranial articular process Caudal articular process Intervertebral disc space Body Endplates Spinous process Transverse processes Pedicles
3 5 6 2
4

2.

7 1 8

Intervertebral disc space Intervertebral foramen

4. 5. 6. 7. 8.

General Spinal Anatomy

z

Cervical Spine
Positioning z head extended z front limbs pulled caudally z wedge under mid-cervical region

Lateral Cervical Spine

Positioning in Cervical Spine

Well positioned

Poorly positioned

VD Cervical Spine
z z z

Cervical Spine
Seven vertebrae with variable structure C1 or atlas
z

wide wings long thin dorsal spinous process dens with special ligaments

C2 or axis
z z

No disc between C1C2

Cervical Spine
z z z

Thoracic Spine
z

C3-C7 similar in shape C6 has expanded transverse processes Intervertebral disc spaces at C2-3 and C7-T1 are relatively narrow *

Positioning
z z z

front limbs pulled cranially hind limbs pulled caudally wedge under sternum

* *

Lateral Thoracic Spine

VD Thoracic Spine

Thoracic spine
z z z z z

Lumbar Spine
z

Thirteen vertebrae uniform in shape Variable dorsal spinous processes Anticlinal vertebra T 11 * Articular facet conformation changes at T10-11 Intervertebral disc space narrowest at T10-11

Positioning
front limbs pulled cranially z hind limbs pulled caudally
z

Lateral Lumbar Spine

VD Lumbar Spine

Lumbar spine
z z z z

Feline Differences

Seven lumbar vertebrae Accessory process Cranioventrally angled transverse processes L3* and L4* site of attachment of diaphragmatic crura
z z

Curvature of spine Shape of vertebral bodies Very prominent accessory process

Canine

Myelogram
z z z

A special procedure to evaluate the spinal cord, when survey radiography is inconclusive Aqueous non ionic iodinated contrast media is injected into the subarachnoid space Standard lateral and VD views, as well as oblique VDs are obtained of the area of interest

Clinical Correlation

Herniated disc T13 L1

Spinal Column Fracture and Luxation

Spinal Column Subluxation and Vertebral body fracture

Discospondylitis

Spondylosis and Articular Facet Osteoarthitis

13.5 y old Golden

Mineralized Disc Material

(IVDD- Intervertebral Disc Disease)

Vertebral Anomalies

Butterfly Vertebra

Block Vertebrae

Aplastic Dens

Normal