1

Integrated
Anatomy: Imaging
of the Spine
CREATED BY: PAULINA ALTSHULER
MUSCULOSKELETAL COURSE: BACK
ROCKY VISTA UNIVERSITY COLLEGE OF
OSTEOPATHIC MEDICINE
Learning Objective 2

 Be able to identify the spinal anatomy detailed in this powerpoint in

radiographs and on bone models
 Be able to correlate information presented in general MSK lectures and gross
lab with the structural anatomy detailed in this powerpoint

 DISCLAIMER: I am not a radiologist. My goal is for you to be able to identify

the anatomy in a radiograph. The real radiologists will teach you how to
correctly read them!

https://www.etsy.com/listing/16272403
0/1950-human-spine-original-vintage
 Posterior-
Anterior
Radiograph of
Thoracic Spine 3

Pedicles

Transverse process

Left Right
Spinous process
Radiology Note: Another way to visualize the structures
in this view of thoracic vertebrae is to imagine an animal
face: the pedicles are the eyes, the spinous process is
the nose or beak, and the transverse processes are the
ears.

 http://dx.doi.org/10.15766/mep_2374-8265.982
 Posterior-
Anterior TV1
Radiograph of Clavicle
Thoracic Spine TV
4
2 2nd rib
TV
3
TV Transverse process
4
TV Pedicle
5
TV6 Spinous process

TV7

TV8
Body of 6th thoracic vertebra

TV9
Ribs 2-9 articulate with two
vertebrae. As shown here, rib TV1 Region of costovertebral
9 articulates with the superior 0 joint
costal facet of TV9 and the
inferior costal facet of TV8. TV11

TV12
Left Right  http://dx.doi.org/10.15766/mep_2374-8265.982
Lateral Radiograph How are the facets oriented?
of Thoracic Spine
- Vertical in the coronal
plane 5
Pedicle

Vertebral
body

Inferior vertebral notch

Superior vertebral
notch

Spinous process

Transverse
process

Superior/inferior articular
facets

 http://dx.doi.org/10.15766/mep_2374-8265.982
 Anterior-Posterior
Radiograph of
Cervical Spine
6
Odontoid process

Transverse
process
Trachea

Spinous process

TV1

Rib 1
http://www.bangalorespineclinic.co.in/anterior-cer
Right Left vical-spine-surgery-bangalore-spine-clinic.html

http://www.geelongspineclinic.com.au/
 Lateral Radiograph
of Cervical Spine How are the facets oriented?
- Oblique in the coronal
plane
7

Posterior
arch of atlas CV1

Superior/inferior articular
facets CV2
Lamina
Spinous process CV3
of
Vertebral
promens CV4
Anterior
arch of Intervertebral
atlas disc CV5
TV
1
CV6

CV7
http://img.medscape.com/fullsize/migrated/527/719/nf527719.fig1.gif https://thumbs.dreamstime.com/x/human-lateral-cervical-spine-neck-3884647.jpg
 Anterior-Posterior
Odontoid View

Molar teeth
8
Molar teeth
Odontoid process

Superior/inferior articular
https://www.med- facets
ed.virginia.edu/courses/rad/cspine/tech
nique4.html
Body of CV2 Spinous process of
CV2

Right Left
http://image.wikifoundry.com/image/1/5fa8UkCaeXfB0_TiYGDb1A91428/GW400H378
 Anterior-Posterior
Radiograph of Lumbar
Spine and Sacrum
9

LV1

LV Ala
2
Pedicle
LV3 Ventral
sacral
Spinous foramina
process LV4
Transverse
process
LV5

Ala
Body of
sacrum

Right Left
http://www.wikiradiography.net/page/Lumbar+Spine+Br http://radiopaedia.org/cases/normal-sacrum-x-rays-1
eathing+Technique
 Lateral Radiograph
of Lumber Spine
How are the facets oriented?
and Sacrum - Vertical in the sagittal
plane Sacral promontory 10

Sacral canal
LV1
Pedicle
Intervertebr
al foramen
LV2 Median sacral
crest

Transverse LV3
process
Zygapophyseal Sacral
(facet) joint LV4 hiatus

LV5
Spinous process
Sacral promontory

http://image.wikifoundry http://radiopaedia.org/cases/normal-sacrum-x-rays-1
.com/image/1/_xtS0dSxGnY
fMz2I4eNVIQ186681/GW233H
 Oblique Radiograph
of Lumber Spine

11
1. Transverse process

2. Pedicle

3. Superior articular
facet

4. Pars interarticularis

5. Lamina

6. Inf articular facet

7. Spinous process

8. Intervertebral
foramen

9. Intervertebral disc

Anterior Posterior
https://www.mypacs.net/cases/NORMAL-LU http://images.radiopaedia.org/images/21397246/401df54bbfd26d
MBAR-SPINE-X-RAY-9914736.html 57
References 12

 Slides adapted from: Lazarus M, Stanley A, Smith L, Brian P.

Thoracic anatomy tutorial using an imaging platform.
MedEdPORTAL Publications. 2014;10:9828. 
http://dx.doi.org/10.15766/mep_2374-8265.9828
 The original authors do not endorse us or the use of this work
 If you log onto the AAMC website and use the Service Tab to access the
Curriculum and Learning Resources Page, click on the MedEdPORTAL
link
 You can search for all types of radiograph lectures and tutorials! We
have used these resources to base our slides off of since they are for
learning! These are fantastic resources
 You can also find the entire powerpoint by following the link above and
logging in.
Extra Resources and Slides 13

 Great radiology tutorial for cervical spine evaluation, courtesy of

the University of Virginia:
https://www.med-ed.virginia.edu/courses/rad/cspine/index.html
 Radiopaedia.org has tons of radiographs (both normal and
pathologic)
 Claripacs.com also has lots of cases with radiographs