Lumbar Spine - PA/AP

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Lumbar Spine - AP / PA
Area Covered	T11 to distal sacrum - including lumbar vertebral bodies, intervertebral joints, spinous and transverse processes, SI joints and sacrum
Pathology shown	Pathology of lumbar vertebrae - fractures, scoliosis and neoplastic processes
Radiographic Anatomy	Lumbar Spine Radiographic Anatomy
IR Size & Orientation	35 x 43 cm larger patient 30 x 35 cm smaller patient Portrait
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or Stationary Grid
Filter	No
Exposure	75 kVp x 35 mAs or breathing technqiue 75kVp x 35 mA with 1.6 seconds exposure time see - lumbar AP breathing technique
FFD / SID	100 cm
Central Ray	CR perpendicular to IR Larger patient - centre to iliac crest (L4-5) Smaller patient - centre to L3 (lower costal margin) (4cm above iliac crest)
Collimation	Four sides of collimation Collimate near IR margins
Markers	Lateral Marker orientation AP
Shielding	Gonadal (check your department's policy guidelines)
Respiration	Suspend respiration on expiration or use breathing technique
Positioning	Supine Patient supine on table Place arms at the side or on the chest Knees flexed (flexion of knees straightens the lumbar spine by reducing lordosis) opening up the intervertebral disk spaces Ensure no rotation of pelvis or torso CR perpendicular to IR Larger patient - centre to iliac crest (L4-5) Smaller patient - centre to L3 (lower costal margin) (4cm above iliac crest) Prone May be performed prone as it places the interspaces more closely parallel with the diverging rays of the X-ray beam see lumbar spine radiography Erect May be performed erect to demonstrate the natural weight bearing alignment of the spine
Critique PACEMAN	Positioning Area Covered Collimation Exposure see imaging vertebral body wedge fractures
Special Notes