I. Commonly used body surface positioning method for each structure of the spine 1, touch and wipe method: This method is the most convenient, most commonly used and more accurate. It is to determine the position of each structure of the spine by palpation using the bony markers of the human body. (1) Tactile erasure of spinous processes: ① Cervical spine: the external occipital ridge, C2 and C7 spinous processes are often used to determine the position of each spinous process in the cervical spine. The extra-occipital ridge is thick and can be accurately palpated by anyone. Along this downward, there is a depression, and then pushing downward, a bony prominence can be touched, which is the C2 spinous process. C2 spine: large, with a bifurcated end. It is visible as a bulge in the upper part of the collar when the head is lowered in a thin person. It can also be palpated by anyone. It can be used as a base point for cervical spine examination. C2 is established and can be palpated by pushing down to clear C3 spine. C7 spine: long and large, mostly undifferentiated. When the head is lowered, it rises at the dorsal junction of the collar. It can also be accurately smoothed out. The position of C6 and C5 spines can be determined by touching upward along them. Only the C4 spine is not easily accessible. However, the position of the C3 and C5 spines can be inferred from the marked spines. In about 20% of people, the C6 spine is longer than the C7 spine. In some individuals, the T1 spine is longer than the C7 spine. Attention should be paid to the differentiation. L4 spine, or L4.5 interspinous, is located on the line of the highest point of the bilateral iliac crest …… S1: the level of the line of the bilateral posterior superior iliac spine, is equivalent to S1 vertebrae. Therefore, the S1 middle crest can also be located more accurately. Therefore, L3, L4 and L5 spines can be more accurately positioned; even L2 and L1 spines can be basically positioned ③ Thoracic spines: When a person is upright and both upper limbs are naturally lowered, the medial end of the scapular posts are connected at the level of T3 spines. The line of the inferior angle of the bilateral scapulae is level with the T7 spine. Because the spines of C7, T3, and T7 can be more accurately positioned, T1, T2, T3, T4, T5T6, T7, T8, and even T9 and T10 can also be more correctly positioned. (2) Tactile erasure positioning of transverse processes: ①Tactile erasure positioning of cervical transverse processes: C1 transverse process: located at the posterior edge of the sternocleidomastoid muscle at the midpoint of the line connecting the mastoid process and the angle of the mandible. C2 transverse process: located at the junction of the horizontal line of the angle of the mandible and the posterior edge of the sternocleidomastoid muscle. C3 transverse process: located at the junction of the horizontal line of the hyoid angle and the posterior border of the sternocleidomastoid muscle. C4 transverse process: located at the junction between the horizontal line of the proximal superior border of the thyroid cartilage and the posterior border of the same muscle C5 transverse process: located at the junction between the horizontal line of the thyroid cartilage and the posterior border of the same muscle C6 transverse process: located at the junction of the horizontal line of the cricoid cartilage and the posterior border of the same muscle C7 transverse process: it is located below the previous transverse process. It can also be so determined: all touching the posterior edge of the sternocleidomastoid muscle, starting from the tip of the mastoid process, every 1.0-1.5 cm, that is, a transverse process. (2) Positioning of the transverse processes of the thoracic vertebrae: it is not easy to palpate and erase. ③Touch and erase positioning of the transverse processes of the lumbar spine: L3 transverse process: the easiest to touch and erase. It is at or slightly below the junction between the outer edge of the sacral spine and the 12th rib. Another method: the doctor spreads the thumb and index finger as far as possible and places them on the patient’s lumbar ribs, with the radial side of the index finger close to the patient’s rib arch, and the tip of the thumb pointing to the tip of the L3 transverse process. L4 and L2 transverse processes: Since the L3 transverse process can be fixed, its upper and lower parts are the L2 and L4 transverse processes. L5 transverse process: It is located slightly above the posterior superior iliac spine. (3) Tactile smear positioning of the articular synapse: on both sides of the spinous process, a series of bead-like bony elevations can be palpated when pressed hard, which is the articular synapse. The cervical and lumbar articular processes are deeper, while those of the thoracic spine are shallower, and the latter are easier to erase. (4) vertebral body: the L3 lumbar vertebral body flat umbilicus. Touch wipe method of positioning method, although simple and practical, but because of individual development, fat and thin vary, pathological changes vary widely, so the accuracy is poor. 2, than shift method: that is, from the individual’s X-ray film, measured the specific data between the structures, and then proportional (that is, this data divided by the magnification or reduction rate of the X-ray film), the data will be moved to the human body, in order to determine the body surface location of the structures. The specific methods are as follows: (1) Cervical spine spine positioning: From the lateral cervical spine film, the distance from the C2 tip to the C7 tip of the film can be clearly measured. Moreover, the distance from the tip of C2 spinous process to the tip of C3 spinous process and from C3 to C4 spinous process can also be measured; and so on, the position of each cervical spinous process of the cervical spine can be accurately measured on a line lateral film. The C2 and C7 spinous processes of any person can be accurately touched and smeared clearly. Therefore, the distance between C2 and C7 can also be measured on the human body. The position of each spinous process of the cervical spine can be accurately marked according to the following calculation. If the C2-C7 on the X line is 15cm, and the C2-C7 on the human body is 10cm, the magnification: 15cm/10cm=1.5. If you need to know the position of the C4 spinous process on the human body. Then measure the C2-C4 on the X-ray is 6cm. then the C4 spine on the human body, then should be located under the C2 spine on the human body: If the location of the C5 on the human body is to be determined. Then measure C2-C5 on the X-ray = 7.5cm. Then the distance of C2-C5 on the human body should be 7.5cm/1.5=5cm at. (2) The spine of the lumbar spine can be positioned in the same way. Only the thoracic spine is a little more difficult. In addition, the use of lateral film, but also a rough estimate of the depth of the epidermis to the yellow ligament. (3) The location of the upper and lower joints, transverse processes, laminae gaps, and laminae spacing can be shown on the cervical, thoracic, and lumbar orthopantomographies. Thus, the numerical relationship between them can also be measured. Therefore, it can also be marked on the surface of the body by the ratio shift method. (3) Application of body surface positioning of spinal structures (1) The position of interspinous processes can be determined when the position of the spinous processes is known: (2) The position of the interspinous processes can be determined when the position of the intervertebral foramen and the outlet of the spinal nerve roots are known. (3) If the position of the spinous process is known, the position of the vertebral body and spinal cord segments can be determined. The relationship between the three in normal adults and the distribution of each spinal nerve root, the lesion area, and the segmental distribution on the body surface. The C5 spinal nerve roots are subjected to radical compression and present with lateral pain or paresthesias in the upper extremities above the shoulder and wrist, with the most pronounced involvement of the triangle and significant pressure pain in the C4 and C5 spinous processes and the C4-5 paraspinal area. The imaging abnormalities seen should also be in the same segment of the cervical spine. The C6 spinal N root is subject to radical pressure, and the abnormal sensory site is also the shoulder and radial aspect of the upper extremity, but may radiate 1 or 2 fingers. The biceps is heavily involved; the biceps reflex is abnormal; the C5 and C6 spinous processes and C5-6 paraspinal pressure are heavy. The abnormalities in imaging are the same as those seen in the nodes. When the C7 spinal N root and C8 spinal N root are involved, the symptoms, signs and imaging abnormalities should also corroborate each other for a reliable diagnosis. The clinical symptoms, signs, and imaging abnormalities of lumbar disc herniation in different segments, and the compression of different lumbar spinal nerve roots, should all be mutually corroborative. However, it should be noted that in the thoracolumbar segment, the length difference between the spinal and spinal cord segments is greater than that of the cervical segment. Therefore, in the case of segmental skin sensory abnormalities caused by spinal or spinal cord lesions, the site of pressure pain in the spinous process is different from that of the cervical segment. The lower abdominal dermatomes are innervated by the T11-12 spinal N roots. The sensory abnormality in this area, in the case of spinal cord lesions, is in the T11-12 segment of the spinal cord. This area corresponds to the T8-9 spine. It should be T8 and T9 spine pressure pain. If the spinal lesion is caused by a spinal lesion, it should be T11 and T12 spinal pressure pain. If the anterolateral segmental sensation of the lower leg is abnormal: it is a manifestation of radical pressure on the L5 spinal N root. If it is caused by lumbar disc herniation, it should be L4-5 disc herniation. The pain is L4 and L5 spinous process pressure. If it is caused by a spinal cord lesion, it is the L5 segment of the spinal cord; it corresponds to the T12 spinous process and the L1 vertebral body segment. Then it is T12 and L1 spinous process pressure pain.