15.1. METHODS OF DIAGNOSTIC RADIOLOGY
The main methods of diagnostic radiology in vertebrology are MRI and CT as the most informative in the diagnosis of many diseases and injuries. However, the X-ray method still has some importance in the primary diagnosis of spinal pathology.
15.1.1. Radiological method
X-ray examination of the spine (spondylography)
X-ray examination of the spine must be performed in two mutually perpendicular views: posteroanterior and lateral. In addition, the X-rays in oblique views are produced in order to display some anatomical details, such as the intervertebral joints and foramen. In order to determine the changes in the intervertebral discs and to study the motor function of the cervical and lumbar spine, a functional examination is carried out with the implementation of spondylograms in the lateral view with maximum flexion and extension of the spine.
X-ray images of the cervical spine show four lower cervical vertebrae in the direct view, as the upper vertebrae are overlapped by the lower jaw and occipital bone. In order to study the I and II cervical vertebrae, the X-ray is performed in the frontal view through the open mouth. In this case, the X-ray visualizes the lateral masses of the I cervical vertebra and its transverse processes, the body and dens of the II cervical vertebra. The joint X-ray gap between the lateral masses of the I and articular processes of the II cervical vertebrae ("lower joint of the head") is clearly visible. With the appropriate position of the head, the gap between the occipital condyles and the lateral masses of the first cervical vertebra ("upper joint of the head") is visible. On this X-ray image, the traumatic damage to the dens, destructive or degenerative-dystrophic changes can be identified.