the lateral doesn't include the C7/T1 interface. CT scan should be thin slices, ideally 1.5 mm or less. It should include first thoracic vertebra. Evaluation CT scan or X-ray images are evaluated for the presence or absence of directly visible fractures. In addition, indirect signs of injury by the vertebral column are incongruities of the vertebral lines, and/or increased thickness of the prevertebral space: After imaging If the patient is not expected to be clinically evaluable within 48–72 hours because of severe head or multiple injuries, they should remain immobilized until a time when such an examination is possible. A 64-slice CT with reconstructions does not entirely rule out ligamentous injury leading to instability, but is a practical means of identifying the majority of C-spine injuries in obtunded patients. MR C-spine has frequent false-positives, limiting its usefulness. In these cases, a consultation with a Spine Surgery specialist is prudent. See also Cervical fracture Spinal cord injury References External links Wilderness Medicine Protocols State of Maine EMS Protocols NEXUS Criteria for C-Spine Imaging Canadian C-Spine Rule Emergency medicine Injuries of neck