Hello everyone,
I’m going to review the ABCS of reading a c-spine CT in today’s Trauma Tuesday. It’s something we order a lot of in the ED, so it’s good to have a standardized approach, just like we do with CXRs.
A = alignment: Best evaluated in the mid-sagittal view, evaluate the 4 smooth curves formed by the anterior and posterior surfaces of the vertebral bodies and the bases/tips of the spinous processes.
B = bones: In addition to looking at the vertebral bodies and spinous processes for breaks or loss of height, pay special attention to the arches/ring of C1 and the dens of C2.
C = cartilage: Assess the spaces between each vertebra, looking for widening, narrowing, or asymmetry.
S = soft tissue: Look at the pre-vertebral soft tissues in the mid-sagittal slice. Note that the soft tissue contour should parallel the vertebral bodies and is narrow from C1-C4.
There’s a couple of “spaces” to be aware of which I think is much easier to see rather than explain in written form so in the references below is a link to a short, helpful video that explains all this while showing you it at the same time!
References