LAT CERVICAL - Lateral Projection of Cervical Spine

Cervical Lateral Position Diagram

Reference Cervical Lateral Radiograph

Exposure Factors

60-70

Kilovoltage (kV)

Milliamperage (mAs)

Fine Focus

Focus Type

120-150 cm

Focus-Plate Distance

With Bucky

Configuration

Increased distance: Greater distance to reduce magnification in lateral projection

Increased Focus-Plate Distance

120 - 150 cm

Purpose: Reduce magnification and improve definition in lateral projection

Comparison: Greater than AP cervical (105-115 cm) to compensate for object-plate increase

Visible Anatomical Structures

Should be clearly observed:

Vertebral bodies from C1 to C7
Spinous processes
Uncinate processes
Transverse processes
Intervertebral disc space
Pedicles
Laminae
Intervertebral joints
Skull base

Plate Size and Orientation

18 × 24 cm

Longitudinal

24 × 30 cm

Longitudinal

Longitudinal orientation to cover entire cervical spine from skull base to D1

Patient Positioning

Patient in standing or seated position

Shoulder in contact with the bucky

Mid-sagittal plane of body parallel to grid plane

Shoulders lowered maximally to expose lower cervical vertebrae

Chin slightly elevated to separate jaw from vertebrae

Chassis centered with central ray

Avoid rotation of head or trunk

Central Ray Point

Perpendicular to C4

Location: Directed to the fourth cervical vertebra (C4)

Angulation: Horizontal (no angulation)

Direction: Perpendicular to plate and long axis of neck

Optimal Image Characteristics

Vertebrae C1-C7

All visible without overlap

Disc Spaces

Intervertebral spaces open

Overlaps

Jaw separated from vertebrae

Skull Base

Clearly visible

Processes

Spinous and transverse defined

Alignment

Physiological cervical curvature

BREATHING INSTRUCTIONS

"At the end of expiration, suspend breathing"

Perform exposure at end of expiration
Shoulders in lowest possible position
Allows better visualization of C7-T1
Reduces movement during exposure

Technique: Patient exhales completely and holds breath

Common Technical Challenges

Frequent problems in cervical lateral projection:

Jaw-vertebrae overlap due to insufficient chin elevation
Shoulders not lowered hiding C6-C7-T1 vertebrae
Head/trunk rotation creating oblique images
Excessive magnification due to insufficient focus-plate distance
Poor C7-T1 visualization due to wide shoulders or muscular patients

Solution: Actively lower shoulders and use increased focus-plate distance (120-150 cm)

Patient in Supine Position (Stretcher)

Procedure for patients who cannot mobilize:

Place chassis vertically longitudinally beside the neck
Center chassis at C4
Immobilize chassis with sandbags on sides
Alternative: secure with adhesive tape
Horizontal central ray directed to C4

Trauma priority: Do not move the patient, adapt technique to their position

Patient Instructions

"At the end of expiration, suspend your breathing"

Complete sequence:

1. Place shoulder against bucky
2. Lower shoulders maximally
3. Slightly elevate chin
4. Exhale completely
5. Hold breath
6. Maintain position without moving

Clinical Indications

Cervical trauma

Spondylosis

Facet joint arthritis

Alignment evaluation

Lordosis measurement

Instability