Cervical Spine Series

Overview & Description

Neck x-rays involve a series of films used to diagnose abnormalities of the bones and soft tissues of the cervical spine.

Who is a candidate for the test?

This test may be performed on a person with these symptoms:

acute or chronic neck pain

severe head injury or neck injury

injury to other parts of the spinal column, chest wall, or pelvis

arthritis or other degenerative bone and joint problem

limited movement, numbness, or pain in the arms, hands, or fingers

loss of consciousness

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 gray. Fat blocks even less of the x-ray beam and appears as a darker shade of gray 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 stabilizing collar.

If necessary, the x-ray beam penetration can be altered to better study soft tissue disorders of the neck, including:

inflamed tonsils, or tonsillitis

throat infection

enlarged cervical lymph nodes

foreign body in the upper esophagus, called the cervical esophagus or upper airway

Preparation & Expectations

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. Jewelry, such as necklaces and earrings, and dentures should be removed before the exam.

Results and Values

What do the test results mean?

A specialized doctor called a radiologist will examine the films. The radiologist will forward a verbal and/or written report to the person's personal healthcare provider. The healthcare providers 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 disks and vertebrae

spondylolisthesis, a forward slipping of one vertebrae on the one below

metastatic tumor invasion, or cancer caused by abnormal cells traveling 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 disk problem. These symptoms are first evaluated with a cervical spine series followed by an MRI scan.