POSITIONING: LUMBAR COLUMN ROUTINE 

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♦♦ ROUTINE: AP AND PROFILE ♦♦
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♦ AP:
► Patient Positioning - Supine Position
The patient's supine position with arms along the body and head on pillow (can also be
made in prone or vertical decubitus; see Note).
► Position of the Party:
• Align the midsagittal plane with the RC and the table/grid line.
• Bend knees and hips to reduce lordotic curvature.
• Ensure the absence of chest or pelvis rotation.
► RC:
• RC perpendicular to the RI, centering as follows:
Largest RI (35 × 43)
Direct RC at the level of the iliac crest (space between L4 and L5). The greater RI will include the vertebrae
lumbars, the sacrum and possibly the coccyx.
Minor RI (30 × 45)
Direct the RC at the level of L3, which can be located by palpating the inferior costal margin (4
cm above the iliac crest). This minor RI will include the first five lumbar vertebrae.
• Centralize the RI to the RC.
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♦ Profile:
► Patient Positioning - Lateral Position:
Place the patient in lateral decubitus, with the head on the pillow, knees flexed and
with support between the knees and ankles to better maintain the lateral position and ensure the
patient comfort.
► Position of the Party:
• Align the coronal midplane to the RC and the midline of the table and/or to the RI.
• Place radiolucent support under the waist as needed to arrange the longitudinal axis of the
column parallel to the table (palpate the spinous processes to determine, see Observation.)
• Ensure the absence of chest or pelvis rotation.
► RC:
• RC perpendicular to RI.
Largest RI (35 × 43)
Center at the level of the iliac crest (L4-L5). This incidence includes the lumbar vertebrae, the sacrum and,
possibly the coccyx.
Minor RI (30 × 35)
Center L2-L3 at the level of the inferior costal margin (4 cm above the iliac crest). Includes the five
lumbar vertebrae. Centralize the RI to the RC.
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Source: Bontrager, 8th Edition. #Radiology