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Thoracic and lumbar spine
Flex the knees, place the anode at the head for the T-spine, and read the Scotty dog to check your oblique.
Patient and part
For the AP thoracic spine the patient is supine, knees flexed, not rotated. Place the head at the anode end so the anode heel effect puts less intensity over the thin upper thorax. The lateral thoracic spine is a left lateral with arms raised to 90 degrees and the spine parallel to the table. The AP lumbar spine is supine with knees flexed, which flattens the lumbar curve and opens the disk spaces. The lateral lumbar spine adds waist support. For the zygapophyseal joints, rotate 45 degrees into RPO and LPO positions.