Full Spine Lateral (Stitching)

Stitching Lateral panoramic stitching STD
Objective

Entire spine in lateral view (C1 → pelvis) for assessment of sagittal curves (lumbar lordosis, thoracic kyphosis, sagittal balance) and curves associated with scoliosis.

Positioning

Patient standing with the side against the detector.
Arms raised anteriorly (to free the posterior structures).
Feet shoulder-width apart.
Sequential acquisition with software stitching.
Central ray: perpendicular to the IR.

Centering

T6–T7

DR Parameters

85–95 kV · 20–35 mAs per segment
SID ~150–180 cm · grid required

CR Parameters

85–95 kV · 30–50 mAs per segment · SID ~150–180 cm

Quality criteria

Entire spine from C1 to the pelvis included.
Pelvis included for sagittal balance and pelvic obliquity assessment.
Sagittal curves assessable throughout.
No misalignment between segments.

Common errors

Pelvis not included.
Arms not sufficiently raised (superimposition over the vertebrae).
Movement between acquisitions.
Extreme vertebrae not included.

Practical notes

Essential for measuring lumbar lordosis, thoracic kyphosis and sagittal balance.
Always perform paired with the AP for complete scoliosis assessment.
Always perform weight-bearing.
Paediatric/adolescent patient (<18 years): routine gonadal shielding no longer recommended (AAPM 2021); tight collimation; prefer low-dose systems (EOS/LODOX) if available.