title: Novel Intraoperative Technique to Visualize the Lower Cervical Spine: A Case Series.
abstract: Visualization of the lower cervical spine with a lateral radiograph poses a challenge secondary to encroachment of the shoulders. Applying traction to the arms or taping the shoulders down provides adequate visualization in most patients, but imaging the mid- to lower cervical levels presents a significant challenge in patients with stout necks. We present a variation of the lateral radiograph that is 30º oblique from horizontal and 30º cephalad from neutral and used in a series of patients with stout necks that require anterior instrumentation of the lower cervical spine. We reviewed intraoperative images of 2 patients who underwent anterior cervical spine surgery at our institution, and assessed type of procedure, body mass index, and outcome scores. Our variation provided improved visualization relative to a lateral view and was used intraoperatively to confirm correct-level hardware placement in both patients.
authors: Ryan
authors: R
authors: Rauck
authors: Kari
authors: K
authors: Stammen
authors: Elizabeth
authors: E
authors: Yu
authors: Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH. safdar.khan@osumc.edu.
authors: Safdar N
authors: SN
authors: Khan
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography / Q000379:methods; D012782:Shoulder; D013123:Spinal Fusion / Q000379:methods*; D014143:Traction