Flexion Extension Xrays of Cervical Spine

Flexion extension xrays of cervical spine are Dynamic motion studies of the neck.  Flexion extension xrays of cervical spineare helpful in eliciting less than obvious instability of the cervical spine and assessing the healing results of the cervical spine following trauma and other pathologies.

What Is Dynamic Radiography?

Flexion extension xrays of cervical spine are taken in different positions of neck i.e. flexion and extension. The xrays are then studied for relations of vertebral bodies and the preservation or loss of anatomical alignment which may be indicated by

• Development of deformity in particular position
• Inability to maintain normal relationships of vertebrae on change of position.
• More than desired motion of a vertebral segment on movement.

Any of the above indicates an imbalance of ligamentous structure.

Some times, in dynamic radiography, additional distraction forces may be applied by putting traction and the displacement may be studied. Any abnormal displacement indicates insufficiency.

The xray above and below are of 38 years old lady who suffered from chronic neck pain. Her routine xray of cervical spine revealed a kyphotic deformity at C4-C5 level. Flexion extension xrays of cervical spine views were done. While the deformity got corrected in extension view, it got exaggerated in flexion suggesting dynamic instability. [Images above and below]

When Flexion Extension Xrays of Cervical Spine are Done?

Flexion extension xrays of cervical spine  are  done when initial investigations suggest near normal spine or reveals a deformity which needs to be determined as fixed or correctable. Flexion extension xrays of cervical spine  are also done when there is enough evidence to suggest instability.

The problem can be as a result of trauma or some other disease. In trauma, however , Flexion extension xrays of cervical spine are usually contraindicated for patients with known acute cervical spine fractures and dislocations.  They are deferred  until a patient has documented absence of cognitive impairment, has overcome the acute post injury state, and has no obvious signs of spinal trauma.

In fact better imaging modalities like CT or MRI obviate the need for flexion extension xrays of cervical spine in cases of patients with trauma.