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Cervical Spine XRay

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1. Cervical Spine XRay in Disc Herniation

Cervical Spine XRay in Disc Herniation Cervical Spine XRay in Disc Herniation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cervical (...) Spine XRay in Disc Herniation Cervical Spine XRay in Disc Herniation Aka: Cervical Spine XRay in Disc Herniation , C-Spine XRay in Herniated Disc II. Indications: Suspected Cervical Disc Herniation Persistent symptoms despite 2 weeks rest Neurologic deficit III. Views Anteroposterior Oblique (shows foramen) IV. Findings: Disc Herniation Chronic disc degenerative disease Decreased disc space height Osteophytes Anteriorly and Posteriorly Encroachment of Osteophytes on foramen Acute disc disease Xray

2018 FP Notebook

2. Cervical Spine XRay

Cervical Spine XRay Cervical Spine XRay Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cervical Spine XRay Cervical Spine XRay Aka (...) : Cervical Spine XRay , C-Spine XRay , Cervical Spine XRay in Acute Traumatic Injury II. Efficacy: Blunt Trauma Inadequate for most patients ( is preferred) Adequate visualization of the entire is achieved in <30% of plain film C-Spine XRays Misses up to 16% of c-spine s in seriously injured, obtunded blunt patients However, NEXUS found that adequate 3-view C-Spine XRays have >99% for significant III. Indications: Acute Trauma Decision rules for imaging in general See See See Cases in which plain C-Spine

2018 FP Notebook

3. Cervical Spine XRay in Disc Herniation

Cervical Spine XRay in Disc Herniation Cervical Spine XRay in Disc Herniation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cervical (...) Spine XRay in Disc Herniation Cervical Spine XRay in Disc Herniation Aka: Cervical Spine XRay in Disc Herniation , C-Spine XRay in Herniated Disc II. Indications: Suspected Cervical Disc Herniation Persistent symptoms despite 2 weeks rest Neurologic deficit III. Views Anteroposterior Oblique (shows foramen) IV. Findings: Disc Herniation Chronic disc degenerative disease Decreased disc space height Osteophytes Anteriorly and Posteriorly Encroachment of Osteophytes on foramen Acute disc disease Xray

2015 FP Notebook

4. Cervical Spine XRay

Cervical Spine XRay Cervical Spine XRay Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cervical Spine XRay Cervical Spine XRay Aka (...) : Cervical Spine XRay , C-Spine XRay , Cervical Spine XRay in Acute Traumatic Injury II. Efficacy: Blunt Trauma Inadequate for most patients ( is preferred) Adequate visualization of the entire is achieved in <30% of plain film C-Spine XRays Misses up to 16% of c-spine s in seriously injured, obtunded blunt patients However, NEXUS found that adequate 3-view C-Spine XRays have >99% for significant III. Indications: Acute Trauma Decision rules for imaging in general See See See Cases in which plain C-Spine

2015 FP Notebook

5. Cervical Spine Imaging in Acute Traumatic Injury

Cervical Spine Imaging in Acute Traumatic Injury Cervical Spine Imaging in Acute Traumatic Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Cervical Spine Imaging in Acute Traumatic Injury Cervical Spine Imaging in Acute Traumatic Injury Aka: Cervical Spine Imaging in Acute Traumatic Injury , Acute Cervical Spine Imaging II. Indications: C-Spine Imaging in Acute Traumatic Injury Decision Rules Strong indications Mental status less than alert or patient intoxicated Focal neurologic deficit Posterior midline neck tenderness Patient reports (especially if out of proportion to physical findings) Cancer (especially metastatic cancer

2018 FP Notebook

6. Pediatric Cervical Spine Injury

Most commonly fatal at the accident scene s may provoke the distraction Findings on CT Joint widening between occiput-C1 or C1-C2 (unilateral or bilateral) Retropharyngeal space widening on C2 VIII. Types: Dens Fracture Age Age <7 years old Findings on Peg of the dens is displaced anteriorly occurs at the synchondrosis (weak bony ) IX. Imaging: Cervical Spine XRay Precautions can not rule out high suspicion Pediatric CT or MRI is indicated where suspicion is high Odontoid view Unreliable (...) Pediatric Cervical Spine Injury Pediatric Cervical Spine Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Pediatric Cervical

2018 FP Notebook

7. Cervical Spine Injury

removed Palpate for tenderness, swelling, or instability Reapply Cases where a C-Spine Imaging is not needed See ( ) Cervical Indications Younger, otherwise healthy patients No focal exam findings but who cannot be cleared with alone Indications for instead of XRay (most cases in which C-Spine Imaging is required) Focal findings (e.g. neurologic or significant localized c-spine tenderness) Older patients or those with altered baseline (e.g. prior surgery, DJD) Indications is the first-line study (...) Cervical Spine Injury Cervical Spine Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cervical Spine Injury Cervical Spine

2018 FP Notebook

8. Scoliosis XRay

Angle , Scoliosis Survey X-Ray II. Indication Evaluation III. Approach Obtain Posteroanterior (PA) XRays of the full spine Posteroanterior view minimizes radiation Patients back is to XRay Source XRay tube positioned 6 feet from 14"x36" cassette Correct with block under foot IV. Measurement: Naming the curve Choose a to be the apex Apex is furthest deviating Apex forms the peak of the convexity Define the XRays right side PA Spine views are reverse of normal Described as if patient examined from (...) behind Patient's right side is physician's right side Define direction of curve (left or right) Based on the direction of the convexity Left curve has its apex on the left Define curve location based on apex e level Cervical Thoracic Thoracolumbar (apex at T12 or L1) Lumbar Double Major (2 curves in different regions) V. Measurement: Cobb Angle Diagram Technique Select most tilted e above the apex Draw a line along the top of the e Extend the line into the margin of the Xray Drop a line down

2018 FP Notebook

9. Cross-Table Lateral C-Spine

Cross-Table Lateral C-Spine Aka: Cross-Table Lateral C-Spine , Lateral Cervical Spine XRay , Lateral C-Spine XRay II. Indications III. Evaluation: General (Mnemonic: ABCDS) Adequate film and Alignment Bony landmarks Cartilaginous space and curvature Discs Soft tissue spaces IV. Evaluation: Adequate film criteria Visualize all seven e (including C7-T1) Major pitfall: Inadequate visualization of the entire from C1 to the top of T1 C7-T1 is a common site of (visualization is critical) Maneuvers (...) Cross-Table Lateral C-Spine Cross-Table Lateral C-Spine Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cross-Table Lateral C-Spine

2018 FP Notebook

10. C-Spine CT

-Spine over XRay In most cases imaging is performed with CT Alternatives such as is often inadequate with up to 20-40% C7 difficult visualization (e.g. obese or muscular patients) Abnormal cervical anatomy such as or in elderly (especially C1 and C2 injuries) III. Adverse Effects See Concentrated radiation to skin of neck and IV. Efficacy: Acute Traumatic Injury for : 98% CT alone with axial slices <3mm has 100% NPV for unstable May someday obviate need for or MRI in obtunded patients (follow local (...) C-Spine CT C-Spine CT Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 C-Spine CT C-Spine CT Aka: C-Spine CT , CT C-Spine , Cervical

2018 FP Notebook

11. Study Using the CervicalStim Device Following Cervical Fusion

to Group/Cohort Intervention/treatment CervicalStim PEMF group all subjects will receive active CervicalStim bone growth stimulator Device: CervicalStim bone growth stimulator Orthofix CervicalStim bone growth stimulator Outcome Measures Go to Primary Outcome Measures : cervical fusion rate [ Time Frame: 12 months ] fusion rate assessed via radiographic confirmation (Xray and CT) Secondary Outcome Measures : Device Compliance [ Time Frame: 6 months ] actual minutes per day device was used compared (...) Study Using the CervicalStim Device Following Cervical Fusion Study Using the CervicalStim Device Following Cervical Fusion - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Study Using the CervicalStim

2017 Clinical Trials

12. Pediatric Cervical Spine Injury

Most commonly fatal at the accident scene s may provoke the distraction Findings on CT Joint widening between occiput-C1 or C1-C2 (unilateral or bilateral) Retropharyngeal space widening on C2 VIII. Types: Dens Fracture Age Age <7 years old Findings on Peg of the dens is displaced anteriorly occurs at the synchondrosis (weak bony ) IX. Imaging: Cervical Spine XRay Precautions can not rule out high suspicion Pediatric CT or MRI is indicated where suspicion is high Odontoid view Unreliable (...) Pediatric Cervical Spine Injury Pediatric Cervical Spine Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Pediatric Cervical

2015 FP Notebook

13. Cervical Spine Imaging in Acute Traumatic Injury

Cervical Spine Imaging in Acute Traumatic Injury Cervical Spine Imaging in Acute Traumatic Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Cervical Spine Imaging in Acute Traumatic Injury Cervical Spine Imaging in Acute Traumatic Injury Aka: Cervical Spine Imaging in Acute Traumatic Injury , Acute Cervical Spine Imaging II. Indications: C-Spine Imaging in Acute Traumatic Injury Decision Rules Strong indications Mental status less than alert or patient intoxicated Focal neurologic deficit Posterior midline neck tenderness Patient reports (especially if out of proportion to physical findings) Cancer (especially metastatic cancer

2015 FP Notebook

14. Cervical Spine Injury

removed Palpate for tenderness, swelling, or instability Reapply Cases where a C-Spine Imaging is not needed See ( ) Cervical Indications Younger, otherwise healthy patients No focal exam findings but who cannot be cleared with alone Indications for instead of XRay (most cases in which C-Spine Imaging is required) Focal findings (e.g. neurologic or significant localized c-spine tenderness) Older patients or those with altered baseline (e.g. prior surgery, DJD) Indications is the first-line study (...) Cervical Spine Injury Cervical Spine Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cervical Spine Injury Cervical Spine

2015 FP Notebook

15. Scoliosis XRay

Angle , Scoliosis Survey X-Ray II. Indication Evaluation III. Approach Obtain Posteroanterior (PA) XRays of the full spine Posteroanterior view minimizes radiation Patients back is to XRay Source XRay tube positioned 6 feet from 14"x36" cassette Correct with block under foot IV. Measurement: Naming the curve Choose a to be the apex Apex is furthest deviating Apex forms the peak of the convexity Define the XRays right side PA Spine views are reverse of normal Described as if patient examined from (...) behind Patient's right side is physician's right side Define direction of curve (left or right) Based on the direction of the convexity Left curve has its apex on the left Define curve location based on apex e level Cervical Thoracic Thoracolumbar (apex at T12 or L1) Lumbar Double Major (2 curves in different regions) V. Measurement: Cobb Angle Diagram Technique Select most tilted e above the apex Draw a line along the top of the e Extend the line into the margin of the Xray Drop a line down

2015 FP Notebook

16. Cervical Neck Strain

V. Signs: Limited Cervical Sprain Limited Range of Motion No pain No s No radiculopathy Normal VI. Radiology: C-Spine XRay Loss of normal cervical lordosis with neck spasm Obtain flexion and extension views Rule-out instability Abnormal translatory displacement Posterior translation > 3.5 mm adjacent e VII. Radiology: C-Spine MRI Not indicated if neurologic changes absent References VIII. Management Avoid home use of soft for treatment Prolonged immobilization slows healing Early active range (...) the result of being struck from behind by a fast-moving vehicle, in an automobile accident. (From Segen, The Dictionary of Modern Medicine, 1992) Definition (PSY) Soft tissue injury of cervical spine due to sudden hyperextension or hyperflexion or hyperrotation of neck or limbs. Concepts Injury or Poisoning ( T037 ) MSH SnomedCT 390011007 , 209562006 , 209558000 , 276469007 , 157304007 , 269334007 , 39848009 English Injuries, Whiplash , Whiplash Injuries , Whiplash Injury , Injury, Whiplash , Accelerat

2018 FP Notebook

17. Cervical Disc Disease

to consider: Flexion and extension views tic neck injury evaluation in adults at acute emergency visit Not as useful in evaluating cervical disc or radiculopathy (without myelography) Avoid in children Consult with local experts Consider MRI instead if XRay not diagnostic Indicated urgently for red flags (see above), progessive neurologic deficit or myelopathy, epidual abscess Indicated routinely for refractory course beyond 6 weeks of conservative therapy High rate of false positives (57% over age 64 (...) years) and false negatives in Cervical Radiculopathy CT with Myelography (requires spinal contrast injection) May offer definitive evidence where MRI is non-diagnostic in Cervical Radiculopathy Offers alternative for patients who cannot undergo MRI XV. Diagnostics (EMG) Consider in atypical and distinguishing proximal from distal cause XVI. Precautions Thorough is critical to identify deficits Cervical Radiculopathy with a neurologic deficit should be addressed promptly (consult spine surgery

2018 FP Notebook

18. Cervical Spondylotic Myelopathy Surgical Trial

, functional outcomes instruments (SF-36, Oswestry Neck Disability Index, and EuroQol-5D) will be collected annually at years 2,3,4 and 5. Pre-op imaging will include a cervical MRI and cervical CT as well as cervical flexion/extension films and standing cervical-thoracic-lumbar-sacral x-ray . A cervical MRI will be performed at 3 months. At 1 year (randomized patients only) will undergo cervical flexion/ extension xrays and standing cervical-thoracic-lumbar-sacral x-ray . A cervical CT will be performed (...) months and 1 year ] patient diary capturing out of pocket health expenses related to cervical surgery Work Status [ Time Frame: pre-operative, 1, 3 and 6 months and 1 year ] Sagittal Balance Measurements [ Time Frame: Pre-op and 1 year ] standing cervical-thoracic-lumbar-sacral xrays Number of participants with unresolved swallowing difficulty (complication) at 3 months [ Time Frame: 3 months ] Complication is considered swallowing difficulty Eligibility Criteria Go to Information from the National

2014 Clinical Trials

19. Cross-Table Lateral C-Spine

Cross-Table Lateral C-Spine Aka: Cross-Table Lateral C-Spine , Lateral Cervical Spine XRay , Lateral C-Spine XRay II. Indications III. Evaluation: General (Mnemonic: ABCDS) Adequate film and Alignment Bony landmarks Cartilaginous space and curvature Discs Soft tissue spaces IV. Evaluation: Adequate film criteria Visualize all seven e (including C7-T1) Major pitfall: Inadequate visualization of the entire from C1 to the top of T1 C7-T1 is a common site of (visualization is critical) Maneuvers (...) Cross-Table Lateral C-Spine Cross-Table Lateral C-Spine Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cross-Table Lateral C-Spine

2015 FP Notebook

20. C-Spine CT

-Spine over XRay In most cases imaging is performed with CT Alternatives such as is often inadequate with up to 20-40% C7 difficult visualization (e.g. obese or muscular patients) Abnormal cervical anatomy such as or in elderly (especially C1 and C2 injuries) III. Adverse Effects See Concentrated radiation to skin of neck and IV. Efficacy: Acute Traumatic Injury for : 98% CT alone with axial slices <3mm has 100% NPV for unstable May someday obviate need for or MRI in obtunded patients (follow local (...) C-Spine CT C-Spine CT Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 C-Spine CT C-Spine CT Aka: C-Spine CT , CT C-Spine , Cervical

2015 FP Notebook

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