- ideally, spinal imaging should be taken erect in the setting of non-trauma to give a functional overview of the lumbar spine
- all imaging of patients with suspected spinal injury must occur in the supine position without moving the patient
- in the lateral decubitus position, position the patient so that the humeri are extended 90 degrees to the thorax, with the elbows flexed so that the forearms are parallel to the thorax. Spinal curvature in the AP projection will determine if a right lateral or a left lateral is performed.
- when implementing horizontal beam technique, ensure the distal upper limbs are not overlying the region of interest. Ask the patient to cross their arms over their upper thorax, or to extend them in a similar position to that achieved in the lateral decubitus position
- at the last possible moment, instruct the patient to ‘bend forward’ from the lower back, flexing their lower spine
- at the last possible moment, instruct the patient to ‘lean back’ from the lower back essentially extending their lower spine