Over rotation of more than 45° would cause one pedicle to be foreshortened while the other pedicle aligns to the midline of the vertebral bodies 2. If underrotated, the foramina will be narrowed and a sternoclavicular joint would be superimposed over the vertebral column 3. To demonstrate the intervertebral foramen of the c-spine open, it is necessary to achieve adequate rotation of the vertebral column, usually at 45°. for example, an LPO will demonstrate the right foramina.remember that for AP Oblique cervical spine positioning the patient will either be in an RPO or LPO position and that posterior obliques demonstrate the foramina opposite to your patient positioning 4.using a larger source to image distance will decrease the magnification of the image and improves acuity 2.make sure that any removable artefacts such as earrings, glasses or metal dentures are removed to avoid obscuring the anatomy of interest.intervertebral foramina of the side positioned further from the image receptor should be demonstrated open.patient’s head should be in a lateral position to prevent mandibular superimposition over the vertebral bodies of the cervical spine.all of the cervical spine should be included from C1-T1.inferiorly to include to at least T1 (EAM to sternal notch). superiorly to include all of C1/base of skull.anteriorly to include the soft tissue of the neck.A small foam dowel is positioned at the base of the neck for support. The sides are padded with foam or Velcro pads to secure the cervical spine from side to side, permitting only forward and backward movements. laterally to include the entire cervical spine and its spinous processes To perform flexion and extension MRI, the neck is positioned in the center of the coil on a head holder.C4 at or just above the level of the hyoid bone.the face is in a lateral position with the interpupillary line perpendicular to the image receptor.the thorax and cervical spine is at 45° to the image receptor.patient is standing erect with either the left or right posterior side closer to the image receptor.It is an updated method of assessing spinal motion compared to the standard flexion/extension. Vertebral Motion Analysis, or VMA, is an FDA-cleared system for assessing lumbar and cervical spinal motion. Moving the patient's head or neck, or removing a cervical collar could be detrimental. Swift Imaging has the region’s only real time x-ray to view spinal motion like a movie known as Vertebral Motion Analysis (VMA). Note: Such views should not be performed on trauma patients without the strict instructions of a qualified clinician who has reviewed the lateral cervical spine image or CT of the cervical spine. This projection can be used to visualize pathology involving the adjacent soft tissue structures or cervical spine, especially stenosis of the intervertebral foramina.
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