Imaging of the Cervical Spine > Interpretation > Alignment


Assess four parallel lines. These are:

1. Anterior vertebral line (anterior margin of vertebral bodies)
2. Posterior vertebral line (posterior margin of vertebral bodies)
3. Spinolaminar line (posterior margin of spinal canal)
4. Posterior spinous line (tips of the spinous processes)

These lines should follow a slightly lordotic curve, smooth and without step-offs. Any malalignment should be considered evidence of ligmentous injury or occult fracture, and cervical spine immobilization should be maintained until a definitive diagnosis is made.

Sometimes, misalignment may be physiological.

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