SPINAL LIGAMENT INJURY (INSTABILITY)
Spinal support ligament injuries destabilize the spine, cause spinal instabilities and a myriad of symptoms. Often you will hear about the disc herniations, and while they are very painful, spinal ligament injury is worse. Dr. Henry has trained extensively to assess and treat patients with spinal ligament injuries.
The concept of spine instability can often cause confusion among patients and doctors dealing with back and neck pain. Patients, who are more familiar with conditions like herniated discs and compressed nerves, may find the notion alien. On the other hand, doctors, who rely heavily on MRI scans, may overlook this aspect of spinal health entirely.
Despite the importance of identifying unstable back or neck areas for pain relief, it is often necessary to get the following X-Ray stress views: Cervical Hyperflexion, Cervical Hyperextension, Cervical left lateral bending open mouth, Cervical right lateral bending open mouth; Lumbar Flexion and Lumbar Extension.
WHAT IS SPINAL LIGAMENT INJURY (INSTABILITY)?
The spine is divided into three areas: the cervical, thoracic, and lumbar regions. Walking on two legs instead of four creates a challenge in maintaining spine stability. The spine consists of 24 vertebrae that resemble kid's blocks when stacked. Without stability, the entire structure may collapse. Two methods for ensuring stability are strong ligaments to limit motion and multifidus muscles to adjust movement between vertebrae. Instability can occur if ligaments are injured or muscles are misaligned, resulting in excessive vertebra motion and an unstable spine. This instability can cause pain and put strain on spine joints and nerves, leading to nerve pain or sciatica. Therefore, instability should not be overlooked, as it may be the cause of pain even if MRI results look normal.
CAN SPINAL LIGAMENT INJURY (INSTABILITY) BE SEEN ON A NORMAL (STATIC) X-RAY OR MRI?
Regular X-Rays and MRIs are limited in detecting spinal ligament injury (instability) as they are static images and cannot capture movement. Consequently, patients who display normal or unremarkable results on these tests might later be identified with instability as the possible root of their discomfort in the neck or back.
WHAT IS HYPERFLEXION AND HYPEREXTENSION X-RAYS?
To simulate excessive movement in the vertebrae of the spine, a flexion-extension X-Ray can be performed while the patient is in motion. This involves taking X-Ray images during bending and straightening movements. In the case of the lower back, the patient is instructed to bend forward and backward, with X-Rays taken in both positions. Similarly, for the neck, the patient is asked to look down and up while X-Rays are taken.
WHAT IS LATERAL BENDING ANTERIOR POSTERIOR OPEN MOUTH (APOM) X-RAYS?
Lateral bending APOM X-Ray is a type of medical imaging technique used to visualize the spine from a lateral or side view while the patient is bending to one side. APOM stands for "antero-posterior open mouth". With this view the doctor will be able to perform an Atlas Lateral Shift Analysis by evaluation the lateral translation of the Atlas (C1) on Axis (C2) during lateral bending (left & right). Lateral translation of Atlas on Axis is due to a tear or sub-failure of the Accessory and/or Alar ligament. Lateral shift of Atlas on Axis results in a permanently failed bio mechanical coupling of the unit. This can
be a source of traumatically induced Upper Cervical Instability, Atlantoaxial Instability, or Cranio-Cervical Junction Syndrome. Overhangs of 1.7 mm or more
show a poor prognosis. (1, 2)
FORT WORTH CHIROPRACTOR
Our passion at Optimum Wellness Institute is finding the root of the problem to see if we can help you with your injuries. Our doctor has trained extensively and has a great understanding of how to examine and treat patients with spinal ligament injury. Call or text us to schedule your consultation/exam at 469-771-0377. Come see us at Optimum Wellness Institute, 2100 North Main Street, Suite 105 (inside Main Street Injury Clinic), Fort Worth, TX 76164.
Spinal support ligament injuries destabilize the spine, cause spinal instabilities and a myriad of symptoms. Often you will hear about the disc herniations, and while they are very painful, spinal ligament injury is worse. Dr. Henry has trained extensively to assess and treat patients with spinal ligament injuries.
The concept of spine instability can often cause confusion among patients and doctors dealing with back and neck pain. Patients, who are more familiar with conditions like herniated discs and compressed nerves, may find the notion alien. On the other hand, doctors, who rely heavily on MRI scans, may overlook this aspect of spinal health entirely.
Despite the importance of identifying unstable back or neck areas for pain relief, it is often necessary to get the following X-Ray stress views: Cervical Hyperflexion, Cervical Hyperextension, Cervical left lateral bending open mouth, Cervical right lateral bending open mouth; Lumbar Flexion and Lumbar Extension.
WHAT IS SPINAL LIGAMENT INJURY (INSTABILITY)?
The spine is divided into three areas: the cervical, thoracic, and lumbar regions. Walking on two legs instead of four creates a challenge in maintaining spine stability. The spine consists of 24 vertebrae that resemble kid's blocks when stacked. Without stability, the entire structure may collapse. Two methods for ensuring stability are strong ligaments to limit motion and multifidus muscles to adjust movement between vertebrae. Instability can occur if ligaments are injured or muscles are misaligned, resulting in excessive vertebra motion and an unstable spine. This instability can cause pain and put strain on spine joints and nerves, leading to nerve pain or sciatica. Therefore, instability should not be overlooked, as it may be the cause of pain even if MRI results look normal.
CAN SPINAL LIGAMENT INJURY (INSTABILITY) BE SEEN ON A NORMAL (STATIC) X-RAY OR MRI?
Regular X-Rays and MRIs are limited in detecting spinal ligament injury (instability) as they are static images and cannot capture movement. Consequently, patients who display normal or unremarkable results on these tests might later be identified with instability as the possible root of their discomfort in the neck or back.
WHAT IS HYPERFLEXION AND HYPEREXTENSION X-RAYS?
To simulate excessive movement in the vertebrae of the spine, a flexion-extension X-Ray can be performed while the patient is in motion. This involves taking X-Ray images during bending and straightening movements. In the case of the lower back, the patient is instructed to bend forward and backward, with X-Rays taken in both positions. Similarly, for the neck, the patient is asked to look down and up while X-Rays are taken.
WHAT IS LATERAL BENDING ANTERIOR POSTERIOR OPEN MOUTH (APOM) X-RAYS?
Lateral bending APOM X-Ray is a type of medical imaging technique used to visualize the spine from a lateral or side view while the patient is bending to one side. APOM stands for "antero-posterior open mouth". With this view the doctor will be able to perform an Atlas Lateral Shift Analysis by evaluation the lateral translation of the Atlas (C1) on Axis (C2) during lateral bending (left & right). Lateral translation of Atlas on Axis is due to a tear or sub-failure of the Accessory and/or Alar ligament. Lateral shift of Atlas on Axis results in a permanently failed bio mechanical coupling of the unit. This can
be a source of traumatically induced Upper Cervical Instability, Atlantoaxial Instability, or Cranio-Cervical Junction Syndrome. Overhangs of 1.7 mm or more
show a poor prognosis. (1, 2)
- Lateral shift of Atlas on Axis greater than 1.7mm is considered subluxation and associated with poor prognosis for whiplash injury. Krakenes
J, Kaale BR, Moen G, Nordli H, Gilhus NE, Rorvik J. MRI assessment of the alar ligaments in the late stage of whiplash injury- structural
abnormalities and observer agreement. Neuroradiology 2002 Jul;44(7):617-24, PCCRP Official X-ray Guidelines of the ICA, WCA, FSCO, CCP,
pg. 331, Table 1. - Spinal instability for purposes of this report is defined as “excessive motion identified with testing” that is clinically correlated through
examination or other testing means to be causing a motor, sensory or pain problem at that specific level.
FORT WORTH CHIROPRACTOR
Our passion at Optimum Wellness Institute is finding the root of the problem to see if we can help you with your injuries. Our doctor has trained extensively and has a great understanding of how to examine and treat patients with spinal ligament injury. Call or text us to schedule your consultation/exam at 469-771-0377. Come see us at Optimum Wellness Institute, 2100 North Main Street, Suite 105 (inside Main Street Injury Clinic), Fort Worth, TX 76164.
Overlap in chronic symptomology between Atlanto-Axial Instability, Whiplash Associated Disorder (WAD), Post-Concussion Syndrome, Vertebrobasilar Insufficiency, and Barré-Liéou Syndrome. All of the conditions below appear to be due to "Cervical Instability".
Steilen D, Hauser R, Woldin B, Sawyer S. Chronic neck pain: making the connection between capsular ligament laxity and cervical instability. Open Orthop J. 2014 Oct 1;8:326-45. doi: 10.2174/1874325001408010326. PMID: 25328557; PMCID: PMC4200875.
Steilen D, Hauser R, Woldin B, Sawyer S. Chronic neck pain: making the connection between capsular ligament laxity and cervical instability. Open Orthop J. 2014 Oct 1;8:326-45. doi: 10.2174/1874325001408010326. PMID: 25328557; PMCID: PMC4200875.
Other possible symptoms are:
- Facial Pain
- Loss of Voice
- Shoulder Pain
- Scapular Pain
- Pain Radiating (Traveling) Down the Arms/Hands
- Pain Radiating (Traveling) Down the Legs/Feet
- Bladder or Bowel Dysfunction
- Numbness, Tingling, or a Sense of Weakness of Heaviness in the Arms
- Difficulty Breathing
Optimum Wellness Institute
Gonstead Chiropractic
2100 North Main Street
Suite 105 (inside Main Street Injury Clinic)
Fort Worth, TX 76164
Phone (469) 771-0377
Fax (469) 440-0171
Gonstead Chiropractic
2100 North Main Street
Suite 105 (inside Main Street Injury Clinic)
Fort Worth, TX 76164
Phone (469) 771-0377
Fax (469) 440-0171
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