The normal cervical spine and its variations on plain radiography and computed tomography

To detect abnormalities of the injured bony cervical spine, it is necessary to have a thorough knowledge of the normal cervical spine’s anatomy and its variations. It is the purpose of this article to emphasize the visual characteristics of the normal appearances in order to assist in the determination of whether the examination is normal or abnormal. Because of these visual characteristics, it is at times possible to be certain that the examination is normal solely on basis of the plain radiographs. On other occasions, because the plain radiographic appearance of normal and abnormal may overlap, further evaluation with computed tomography is necessary. Rarely, even with computed tomography, the appearance of normal, subacute injury, and acute injury may not be distinguishable.