Radiography of Cervical Trauma

Abstract

To the Editor.— I refer to the letter entitled "Danger of Traction During Radiography for Cervical Trauma" (1982;247:2369). Kaufman et al describe a common radiological problem frequently encountered when dealing with cervical spine trauma (ie, shoulders obscure the lower cervical spine, resulting in inadequate visualization of the lower cervical vertebrae). Caudal traction on the upper extremities is commonly used to remove the shoulders from the area of interest. The authors describe the hazard of caudal traction on the arms while the head is held in a fixed position by cervical traction. When the patient's body is not held stationary, the risk of cervical distraction is substantial. Radiologists at Los Angeles County-University of Southern California Medical Center, a major trauma facility, have often faced the problem of shoulders obscuring the traumatized lower cervical vertebrae and have resorted to several means of overcoming the difficulty, such as obliquelateral Swimmers views, overpenetrated lateral