How is the test performed? X-rays are energy in the form of electromagnetic waves that are produced by an x-ray machine. Tissues that lie in the path of the x-ray beam absorb or block x-rays to varying degrees. These tissue differences or densities affect the final image on the film. Bone blocks most of the beam and appears white. Soft tissue partially blocks the beam and appears grey. Fat blocks even less of the x-ray beam and appears as a darker shade of grey or black.
An x-ray technologist takes the images of cervical spine. The technologist's goal is to get the best image using as little radiation as possible. The standard neck films require precise positioning and usually include the following:
a frontal view of the neck
a side or lateral view of the neck
an "open-mouth" view of the neck
The "open-mouth" view simply involves the person opening his or her mouth while the x-ray is taken. This special view is particularly useful in evaluating the uppermost part of the cervical spine. Other views are often needed, especially if portions of the cervical spine are not seen well or included on the standard views.
These series of cervical spine images may be taken with the person standing, sitting upright, or lying flat. A neck x-ray can be performed on a person with a neck brace or stabilising collar.
If necessary, the x-ray beam penetration can be altered to better study soft tissue disorders of the neck, including:
foreign body in the upper oesophagus, called the cervical oesophagus or upper airway
What is involved in preparation for the test? No special preparation is needed. A woman of childbearing age will be screened for pregnancy using a urine pregnancy test. Jewellery, such as necklaces and earrings, and dentures should be removed before the examination.
What do the test results mean? A specialised doctor called a radiologist will examine the films. The radiologist will forward a verbal and/or written report to the person's personal doctor. The doctors will use the results to establish the next course of action or treatment plan.
Abnormal findings of a neck x-ray include:
degenerative arthritis changes
traumatic or pathologic fracture
spondylosis, a degeneration of the discs and vertebrae
spondylolisthesis, a forward slipping of one vertebrae on the one below
metastatic tumour invasion, or cancer caused by abnormal cells travelling from another part of the body
Any fracture identified on a cervical spine x-ray will require further evaluation with a CT scan and/or an MRI scan. neck pain associated with arm and hand numbness often indicates a vertebral disc problem. These symptoms are first evaluated with a cervical spine series followed by an MRI scan.
Author: Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 6/06/2005 Contributors Potential conflict of interest information for reviewers available on request
