The C-T junction has to satisfactory demonstrated as well as the craniocervical junction. There are seven cervical vertebrae.
C1 (atlas) and C2 (axis) are atypial;
the remainder(C3 to C7) can be considered typical for this discussion.
Alignment criteria are the same for each projection, although not all the projections will show all the lines of alignment.
The following lines are reviewed:
Each typical vertebra is subdivided into a body, two articular masses and a neural arch (laminae, pedicles, spines). For each the following films are reviewed:
A special area with its own features.
Area of most degenerative change, so findings do not always indicate trauma. Disc spaces should be comparable at all levels and of normal height. Facet joint spaces have parallel articular surfaces without subluxation, and are comparable at all levels (except craniocervial junction). In oblique views end on laminae 'shingle'. The interspinous distances (below C2) are comparable leel to level.
Width guidelines exist, but are neither completely sensitive nor completely specific (7mm at C2, 2cm at C7). The soft tissue line should follow the bony contour (i.e. W shaped at the craniocervical junction) down to the level of the larynx, where the esophagus is interposed.
Table 6.1 shows normal prevertebral spaces at the levels from C1 to C7
The cervical spine is functionally differentiated from the remainder of the vertebral column. Its morphology permits wide ranging mobility. It has two normally curves dividing it morphologically and physiologically into upper and lower segments at C2.
The upper cervical segment includes the occiput, atlas (C1) and axis (C2) vertebrae. This is referred to as the craniovertebral region.
The lower segment consists of spinal units from C2 to C7.
The craniovertebral region contains the occiput, atlas and axis. This complex is the most complicated series of articulations in the human body. It has to serve as a transition zone between the normal vertebral joint structures and the completely different skull. A lot of different studies have been done to investigate the movement in this region. For our field of interest especially the range of motion is of importance.
Table 7.1 presents the ranges of movement at the atlanto-occipital and the atlantoaxial functional units.
Tables 7.2-4 give the coupled ranges of movement during each of the principal ranges of movement.
Table 7.5 gives representative values of the range of rotation of the craniovertebral complex.
The two bones atlas and axis have a very special structure:
Grafic 7.1 shows to the atlas with inscriptions of its parts
Grafic 7.2 shows to the axis with inscriptions of its parts
The lower cervical spine consisting of functional spinal units from C2 to C7, also participates in the global mobility of the head. Classically, the movements are described as flexion-extension, lateral-flexion and rotation.
It was found that flexion movement causes a slide of the vertebra upward and forward and that downward and backward movement is caused by extending. In recent studies an important relationship between flexion-extension (sagittal plane rotation) and two translations was found. This relationship was found as a linear one depending on the values of two independent variables; cephalocaudat(Y) and ventrodorsal(Z) translation.
Table 7.6 gives the 95 percent confidence interval for the ranges of flexion-extension, ventrodorsal and cephalocaudad translations.
Table 7.7 shows the rotation ranges for the lower vertical spine.
Grafic 7.3 shows the structure of a normal vertebra in cervical spine with inscriptions of its parts
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