J Manipulative Physiol Ther. 1992 May; 15(4): 217-23.

Evaluation of quality of lateral full spine radiographs: a statistical study.

Greko PJ, Thayer JD.

Palmer College of Chiropractic, Davenport, IA 52803.

OBJECTIVE: This study examines the effects of filtration on X-ray quality in 287 lateral full spine radiographs of human subjects. The impact of the subject's sex and age on the effects of filtration was also examined. DESIGN: X rays obtained with and without filtration were selected at random from various chiropractic clinics in North America. Five college instructors from various clinical backgrounds classified each film as adequate film quality, or as over- or underexposed in each of the cervical, thoracic, lumbar and sacral spinal regions. RESULTS: Log linear analyses showed that the use of filtration produced the best overall film quality, and that film quality decreased as age increased in all spinal regions, regardless of filtration usage. A higher percentage of films of subjects less than 54 yr of age were judged to be of adequate quality when filtration was used. Films of male subjects had better quality in the lower spinal regions; films of females were better in the upper regions. CONCLUSIONS: By the evidence supported by the statistical analyses, it is suggested that lateral full spine films may only be used as a means for postural screenings if filtration is always used, and to take the sex and age of the patient into account in deciding whether to change technique exposure factors or to use sectional views, which would increase the probability of better quality films.