X-Ray Exam: Cervical Spine

What It Is

A cervical spine X-ray is a safe and painless test that uses a small amount of radiation to take a picture of the bones in the back of the neck (cervical vertebrae).

During the examination, an X-ray machine sends a beam of radiation through the neck, and an image is recorded on special film or a computer. This image includes the seven vertebrae in the neck area, the first vertebrae of the thoracic spine, and the disk spaces in between them.

The X-ray image is black and white. Dense body parts that block the passage of the X-ray beam through the body, such as the bones, appear white on the X-ray image. Hollow body parts, such as the airways, allow X-ray beams to pass through them and appear black.

An X-ray technician takes the X-rays. Usually, three different pictures usually are taken of the cervical spine: one from the front (AP or anterior-posterior view), one from the side (lateral view), and another from the front through an open mouth (odontoid view). Occasionally, additional pictures like flexion and extension views of the cervical spine might be needed.

Why It's Done

A cervical spine X-ray can help find the cause of symptoms such as neck, shoulder, upper back, or arm pain, as well as tingling, numbness, or weakness in the arm or hand. It can detect fractures in the cervical vertebrae or dislocation of the joints between the vertebrae.

It's commonly done after someone has been in an automobile or other accident and has had an injury to the head, neck, or back, especially if the person is unconscious or can't describe symptoms for other reasons.

If surgery of the cervical spine is required, an X-ray may be taken to plan for the surgery and to assess the post-operative results. A cervical spine X-ray also can give clues about an infection, tumor, or other abnormalities in the neck bones.

Preparation

A cervical spine X-ray doesn't require special preparation. Your child may be asked to remove all clothing and jewelry from the waist up and change into a hospital gown because buttons, zippers, clasps, or jewelry might interfere with the image. If your child has a suspected neck injury, a collar or brace will be placed around the neck to limit movement to the neck which helps prevent further injury to the neck.

Developing babies are more sensitive to radiation and are at more risk for harm, so if your daughter is pregnant, be sure to tell her doctor and the X-ray technician.

Procedure

Although the procedure may take up to 15 minutes, actual exposure to radiation is usually only a few seconds.

Your child will enter a special room that will contain a table and a large X-ray machine hanging from the ceiling or wall. Parents are usually able to accompany their child to provide reassurance.

Cervical spine X-rays are performed while in a lying position. The technician will position your child, then step behind a wall or to an adjoining room to operate the machine. Three X-rays are usually taken so the technician will return to reposition your child for each. Occasionally, additional X-rays are needed.

Older kids will be asked to hold their breath and remain still for 2-3 seconds while each X-ray is taken; infants may require gentle restraint. Keeping the neck still is important to prevent blurring of the X-ray image.

If your child is in the hospital and can't easily be brought to the radiology department, a portable X-ray machine can be brought to the bedside. Portable X-rays are sometimes used in emergency departments, intensive care units (ICUs), and operating rooms.

What to Expect

Your child won't feel anything as the X-rays are taken. The X-ray room may feel cool due to air conditioning used to maintain the equipment.

Positions required for the X-rays may feel uncomfortable, but they need to be held for only a few seconds. Babies often cry in the X-ray room, especially if they're restrained, but this won't interfere with the procedure.

If you stay in the room while the X-rays are being done, you'll be asked to wear a lead apron to protect certain parts of your body. Your child's reproductive organs also will be protected with a lead shield.

After the X-rays are taken, you and your child will be asked to wait a few minutes while the images are processed. If any are blurred or unclear, the X-rays may need to be redone.

Getting the Results

The X-rays will be looked at by a radiologist (a doctor who is specially trained in reading and interpreting X-ray images). The radiologist will send a report to your doctor, who will discuss the results with you and explain what they mean.

In case of an injury or other emergency, the results of a cervical spine X-ray can be available quickly. Otherwise, they're usually ready in 1-2 days. In most cases, results can't be given directly to the patient or family at the time of the test.

Risks

In general, cervical spine X-rays are very safe. Although any exposure to radiation poses some risk to the body, the amount used in a cervical spine X-ray is small and not considered dangerous. It's important to know that radiologists use the minimum amount of radiation required to get the best results.

Developing babies are more sensitive to radiation and are at more risk for harm, so if your daughter is pregnant, be sure to tell her doctor and the X-ray technician.

Helping Your Child

You can help your young child prepare for a cervical spine X-ray by explaining the test in simple terms before the procedure. You can describe the room and the equipment that will be used, and reassure your child that you'll be right there for support.

For older kids, be sure to explain the importance of keeping still while the X-ray is taken so it won't have to be repeated.

If You Have Questions

If you have questions about why the cervical spine X-ray is needed, speak with your doctor. You can also talk to the X-ray technician before the procedure.