• Skip to main content
  • Skip to primary sidebar
  • Skip to footer
  • General Ortho
  • Procedures
  • Spine
  • Upper Limb
  • Lower Limb
  • Pain
  • Trauma
  • Tumors
  • Newsletter/Updates

Bone and Spine

Orthopedic health, conditions and treatment

Flexion Extension Xrays of Cervical Spine

By Dr Arun Pal Singh

In this article
    • When Flexion Extension Xrays of Cervical Spine are Done?

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

Flexion-extension x-rays of the cervical spine are taken in different positions of neck i.e. flexion and extension. This is called dynamic radiography. The x-rays 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 a 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.

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

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

When Flexion Extension Xrays of Cervical Spine are Done?

Flexion-extension x-rays of the cervical spine are done when initial investigations suggest near the normal spine or reveal a deformity which needs to be determined as fixed or correctable. Flexion-extension x-rays of the 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 x-rays of the cervical spine are usually contraindicated for patients with known acute cervical spine fractures and dislocations.  They are deferred until a patient has documented the 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 X-rays of the cervical spine in cases of patients with trauma.

Spread the Knowledge
  • 12
    Shares
  •  
    12
    Shares
  • 8
  •  
  • 4
  •  

Filed Under: Spine

ebook on fracture care

About Dr Arun Pal Singh

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab.

This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.

You can follow him on Facebook, Linkedin and Twitter

Reader Interactions

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Primary Sidebar

Serratus anterior muscle paralysis causes winging of scapula

Serratus Anterior Paralysis [Long Thoracic Nerve Palsy]

Serratus anterior paralysis is a condition that characterized by pain, loss of shoulder movement and winging of scapula owing to damage or injury of the long thoracic nerve. This nerve evolves from the roots of neck vertebrae (C5-C7) and supplies to serratus anterior muscle that retains the scapula bone to the chest wall. Long thoracic […]

Flexor tendon pulley system of thumb

Flexor Tendon Pulley System of Hand

Flexor tendon pulley system consists of annular ligaments of the fingers or  A pulleys, and cruciate pulleys [C pulleys]. Flexor pulley system consists of following Palmar Aponeurosis Pulley 5 Annular Pulleys 3 Cruciform Culleys. Together, these form a fibro-osseous tunnel on the palmar aspect of the hand through which passes the deep and superficial flexor […]

Classification of scaphoid fractures

Scaphoid Fractures – Classification, Presentation and Treatment

The scaphoid is most frequently fractured carpal bone. Scaphoid fractures account for up to 15% of acute wrist injuries and 50% to 80% of carpal fractures. Scaphoid fractures have been reported in people aged 10-70 years but commonly occur in young, active individuals,  peak incidence being in the second and third decades of life. Scaphoid […]

Open mouth view xray

What Is Open Mouth View X-ray?

An open mouth view x-ray is a special view to visualize upper cervical spine problems especially C1 and C2 vertebrae. Routine anteroposterior cervical spine view shows the spine from  C3  segment and is usually less helpful in diagnosing acute injuries.  Open mouth view x-ray is not done routinely and is ordered when a problem is […]

Different indices for patellar height measurement

Patellar Height Measurement – Insall Salvati, Blackburne-Peel and Caton-Deschamps Indices

Patellar height measurement becomes important in the diagnosis of patella alta and patella baja. Patella alta is a condition where the patella is high riding than its normal position. Patella baja refers to low lying position of the patella. Both conditions have been discussed separately. Measurement of patellar height can confirm or rule out the […]

Shin Splints are Common in Runners

Shin Splints or Medial tibial stress syndrome

Shin splints or Medial tibial stress syndrome is an overuse injury or repetitive stress injury of the shin area [tibial bone]. These affect persons who engage in running and jumping. It affects about 15% of all running-related injuries. It is most often found in runners, and persons playing other sports like football, basketball, soccer, and […]

First Cervical Vertebra -Atlas

Atlas or First Cervical Vertebra [C1]

Atlas is the first cervical vertebra that sits just below the skull. It is also called C1 vertebra. Along with axis, the second vertebra and C7, it falls into the group of atypical cervical vertebrae. Atypical because these have unique features. Axis and C7 or vertebra prominens are discussed separately. Atlas is unique in its […]

Browse Articles

Footer

Pages

  • About
    • Privacy Policy
    • Disclaimer
    • Contact

Featured Article

Forces on Bone – Compression, Tension and Shear

A bone is subjected to various kinds of forces in our day to day life. Some try to compress it, some bend while others rotate. Depending on their … [Read More...] about Forces on Bone – Compression, Tension and Shear

Search Articles

© Copyright: BoneAndSpine.com