The Use of a Modified Fulcrum for Fulcrum Bending Radiographs: A Technical Note

We describe a modified fulcrum design to overcome limitations of a traditional fulcrum. The modified fulcrum is a triangular prism–shaped foam with rounded and padded edges. The 3 faces of the fulcrum represent 3 different heights (17.0 cm, 17.5 cm, and 21.0 cm). For fulcrum bending radiographs of the thoracic curve, the patient is placed on an X-ray table in a lateral decubitus position over the fulcrum. The apex of the appropriate height of the fulcrum is positioned under the rib corresponding to the apex of the curve, such that the ipsilateral shoulder is lifted off the X-ray table for maximum passive bending force to the curve. For fulcrum bending radiographs of the lumbar curve, the fulcrum is positioned directly under the apex of the curve such that the ipsilateral iliac crest is lifted off the X-ray table.