Radiographic Positioning: Radiographic Positioning of the Lumbar Spine

LUMBAR SPINE WITH OBLIQUES, NON-TRAUMA

ROUTINE VIEWS:
AP
RPO
LPO
Lateral
L5-S1 Spot

AP
1. 14 x 17 film
2. Patient supine
3. Film placed so that the center of the film is at crest
4. Bucky
5. 40" SID
6. Central Ray: perpendicular to film
7. Bend knees to reduce curvature of spine

RPO-45o
1. 11 x 14 film
2. Patient recumbent rotate left side of body 45o up from table
3. Film is placed so that the center of the film is 1" above crest
4. Bucky
5. 40" SID
6. Central Ray: perpendicular to film
7. Need to visualize right apophysial joints ("scotty dogs").
8. Mark film side down with Rt. marker

LPO 45o
1. 11 x 14 film
2. Patient recumbent rotate right side of body 45o up from table
3. Film is placed so that the center of the film is 1" above crest
4. Bucky
5. 40" SID
6. Central Ray: perpendicular to film
7. Need to visualize left apophysial joints ("scotty dogs").
8. Mark film side down with Lt. marker

Left Lateral
1. 14 x 17 film
2. Patient is on left side in true lateral position
3. Bucky
4. 40" SID
5. Central Ray: centered to iliac crest
6. Disc spaces should be open

L5-S1 SPOT
1. 8 x 10 film
2. Patient is on left in true lateral position
3. Bucky
4. 40" SID
5. Central Ray: angled 5-10o caudal angle
6. Cone down to L5-S1, joint space
7. Center film 11/2 inches below crest

Flexion and Extension Lumbar Spine (Upon Request
1. Patient standing bearing equal weight on both legs.
2. Have patient lean forward for 1 film - lean backward for 1 film.
3. Central Ray: horizontal beam with film centered 1" above crest