Cervical spine imaging is one of the traditional mainstays of trauma radiography. The lateral cervical spine view is usually a routine view in patients with severe trauma (although increasingly displaced by CT imaging). The emphasis on 'clearing' the cervical spine in major trauma patients reflects the importance of not missing cervical spine injuries. This page considers soft tissue signs of cervical spine trauma.

The assessment of the prevertebral cervical soft tissues can be impossible if the patient (particularly paediatric patients) is swallowing at the time of exposure.

Assessment of the upper cervical prevertebral soft tissues is not possible in this image. The patient is likely to have been swallowing at the time of exposure	The view was repeated with the patient breathing through an open mouth. The upper prevertebral soft tissues are shown to be normal (arrows)

I was asked to repeat this AP cervical spine view by the referring doctor because of an apparent destructive bony process (arrowed). This expiratory view shows that the inferior margins of the vocal cords almost form a right angle against a closed glottis. The subglottic trachea remains fully distended. (1)	The repeat image suggests that this is overlying air, probably in the pyriform fossa of the larynx. Inspiratory view shows the vocal cords are open and the glottic airway is just a little narrower than the subglottic trachea (1)

1. Susan D. John, MD and LeonardE. Swiscbuk, MD Stridor and Upper Airway Obstruction in Infants and Children.RadioGraphics, 643, July 1992