title: Overcoming challenges associated with upright imaging of the cervicothoracic junction: a case report involving a novel repurposing of the O-arm.
abstract: BACKGROUND
  Prior to the mobilization of patients with spinal fractures following treatment, it is important to confirm stability in the upright position.
  
  
  METHODS
  A patient presented with T2 and T3 vertebral body fractures visible on recumbent CT. Supine and upright plain x-rays with additional swimmer's views were deemed suboptimal prior to mobilization. The default configuration of the O-arm was modified to enable imaging in the upright position.
  
  
  RESULTS
  Images utilizing the O-arm were satisfactory and anatomic alignment confirmed in an upright position. It is believed that this is the first time the O-arm has been used for upright diagnostic imaging (off-label application). Excellent visualization of the cervicothoracic junction and upper thoracic regions was obtained in the desired upright position.
  
  
  CONCLUSIONS
  The O-arm was used successfully to image spinal trauma in the upright position and may represent a new application of the device, potentially fulfilling a frequently unmet medical imaging need.
authors.affiliation: Department of Neurosurgery, NorthShore University Health System, Evanston, IL, USA. dkarahalios@northshore.org
authors.forename: Dean G
authors.initials: DG
authors.lastname: Karahalios
authors.forename: Nassir H
authors.initials: NH
authors.lastname: Mansour
authors.forename: Eric A
authors.initials: EA
authors.lastname: Girardot
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Turner
mesh_terms: D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000209:etiology; D056888:Patient Positioning / Q000295:instrumentation* / Q000379:methods*; D011187:Posture; D011856:Radiographic Image Enhancement / Q000295:instrumentation / Q000379:methods; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods*