What specialized radiographs are commonly used to assess flexibility of spinal deformities

• Supine AP side-bending radiographs (Fig. 10-11)

• Supine AP traction radiograph

• Lateral hyperextension radiograph

• Lateral hyperflexion radiograph

• Push-prone PA radiograph

Specialized radiographs are frequently obtained to assist in surgical planning before surgical correction of spinal deformities. Bending films are used to aid in selection of spinal levels that should be included in a scoliosis fusion. Supine AP bending films have been shown to be superior to standing bending films for assessing coronal curve flexibility. Supine AP traction radiographs are helpful in patients with neuromuscular scoliosis to assess curve flexibility and correction of pelvic obliquity. A hyperextension lateral radiograph performed with a bolster placed at the apex of kyphosis may be useful for assessing the flexibility of a kyphotic deformity. A hyperflexion lateral view may be helpful to assess the flexibility of a lordotic spinal deformity.

Figure 10-11. Supine 36-inch long cassette side bending radiographs. (From Asher MA. Anterior surgery for thoracolumbar and lumbar idiopathic scoliosis. Spine State Art Rev 1998;12:701-11, with permission.)

Figure 10-11. Supine 36-inch long cassette side bending radiographs. (From Asher MA. Anterior surgery for thoracolumbar and lumbar idiopathic scoliosis. Spine State Art Rev 1998;12:701-11, with permission.)

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