#Atlanto-Axial instability

[crowpunkcognitivedecline]

update #2 (~11 hours after procedure)

TL;DR: oxycodone helps [and i forgot to mention, but it was explicitly offered to me afterwards, which is really good news if you're considering PRP]--my injected joints can't really support themselves or move, so i had to brace it, but this is normal

thank g-d for oxycodone [which i ended up taking at 5mg, which made pain less distracting]. i can mostly hold my head up, but if it droops, i've had to push it back with my hands. any amount of distraction can make the drooping happen, so i put on my cervical hard collar to limit it and to use as an aid to push my chin up.

stiffness is still present, and i feel a bit like part of my cervical spine are paralyzed, but they're not [as far as i know anyway]--i think it's just stiffness combined with the pain being kind of "lost" by my brain because of the other pain higher up

i did develop a mild/moderate migraine, but i'm very migraine-prone and was injected near my atlanto-axial joint (the point of instability that gave me my current severe migraines), so i can't say if it's the procedure or if the pain/inflammation there just triggered it.

i was generally prepared for most of this, especially the using the cervical collar--i wore one 18+hrs a day for months when my SCI became independently disabling, and i own two, so it wasn't a hassle. ROSM does say that people getting PRP for joints will usually need to use crutches/a sling/etc, so this is normal even for non-disabled patients (ie those with sports injuries)

i just realize i didn’t really clarify the procedure i had—today, i received PRP (platelet-rich plasma) injections to treat joint/ligament/fascia instability and damage, especially in my cervical spine!

it works (to my understanding) by tricking your body into thinking it’s been recently injured so that it activates healing, with the PRP also accelerating that healing.

i’m going to be posting updates in reblogs as they come to me, since PRP for EDS/SCI patients is hard to find firsthand reviews on!

you can learn more about medical PRP on ROSM’s website :)

[clinically-chronically]

Excerpts were taken from the Ehlers-danlos Society's official website.

This has been a long journey with finding answers and going to not one but now 4 different doctors to find the cause of both my intense headaches/migraines, to furthering in declining health, mobility, Hearing and vision loss, and neurological function. It's crucial that us EDS patients go to physicians that know our condition.

My current Neurosurgeon studied under the top Neurosurgeon in the chiari Institute in New York. One of the top Neurosurgeons that work very closely and know very well, with EDS. He even did a speech for the Chiari and Springomyelia foundation about spinal instability.

Needless to say, we did find concrete evidence and answers to my decline in neurological and even mobility function. Something that all of the spine specialists and even one other Neurosurgeon had missed completely because they didn't know exactly what to look for. Cranio-Cervical and Atlanto-Axial instability. Mine is very much pathological and fits exactly how I feel and have been feeling.

The direct cause of this; Ehlers-Danlos Syndrome.

CRASH CORSE: EDS, effects collagen, defective collagen = lose ligaments, lose ligaments caused my spine to be quite unstable from my skull through the second vertebrae, compressing my spinal cord and surrounding nerves.

So, what do we do?

We are doing a Skull to C2 spinal fusion. A spinal fusion is where we, as it says, fuse the spine. However, with rods, plates, screws, bone graph, etc. This will be about a 4 hour surgery. This will be my biggest and first neurosurgery. However, this can very easily, give me some and hopefully a lot of my mobility back, reduce headaches and migraines, reduce or eliminate my neurological deficits, possibly improve my motility in my gut, possibly improve my dysautonomia and hopefully improve my quality of life.

[superspoonie24]

Welcome!

BOOPS WANTED AND WELCOMED. I HAVE NEVER WANTED ANYTHING MORE.

🐾🐈🧡

Congrats! You found me! Now that you have, here’s a little bit about me. 

I’m Lynx, 22, he/they, bipanacetrans boi

I write and occasionally even post stuff! My ao3 is SuckerForLove24. You can check my writings there and also going through (tumblr got rid of my tags will establish new ones eventually) in my blog. I also have writing commissions open. 

I am dealing with chronic pain, and I will be tracking my experience with that through #did you know: pain sucks. (This tag also got deleted by tumblr)

What I have been diagnosed with:

Generalized Anxiety Disorder

Persistent Depressive Disorder

POTS (postural orthostatic tachycardia syndrome)

OH (orthostatic hypotension)

Endometriosis

hEDS (hypermobile ehlers danlos syndrome)

CCI/AAI (cervical cranio instability and atlanto axial instability)

Tumblr got rid of my saved tags. (Fuck you tumblr)

I use this blog to share stuff I like and/or relate to. If you have any questions or want to shoot me an ask, (check #ask aly). I will do my best to respond as soon as possible. I want to make more friends, so don’t hesitate to drop in and send me an ask about chronic pain or fandom. I am multi-fandom and multi-shipper. This is my safe-space, and I hope it can be one for you too. 

Another update! Tumblr got rid of group chats so if you want to talk/vent/ask questions about chronic illnesses/pain DM me

Remember: “You are braver than you believe, stronger than you seem, and smarter than you think.” And, you are so very very loved.  🧡

[diariesofabuggygirl]

Cruisin’ for a Fusion

Well I’ve got some news! Despite the fact that the day before leaving I woke up with a 100 degree fever - the first fever since I was about eight- and some nasty symptoms. Despite waking up the day of leaving with a fever of 102.2 . Despite having one of the worst and fastest hitting seizures I’ve ever had in his office. I did make it to the neuro surgeon in Baltimore.

I was referred to him by my NS in SC for a second opinion before I get any unnecessary spinal surgeries - which is appreciated. Ha ha.

The new guy confirmed my CCI diagnosis, said he couldn’t tell from my MRI if I’ve retethered since my detethering surgery, and found a totally new diagnosis Atlanto-axial instability.

All of these are from my ehlers danlos syndrome. All could be causing all sorts of my symptoms but the new doctor thought my main issues were at c1 and c2. Mom and I can’t agree on whether that was from the old CCI diagnosis or from the new AAI one. But either way I’ll be getting my cervical spine (neck) fused at c1 and c2. So just two will be fused together and not to my skull like I had figured.

So we are gonna try this fusion first but I may need more fused. The upside of just doing these now is that I’ll lose less range of motion (granted I need to lose some because of my EDS seeing as I can basically see behind me) and it could save me from needing things further down fused later in life. It could also help my tethered cord symptoms and if it doesn’t we might go back in and detether me again seeing as they can be really hard to see on MRIs.

Basically my neck bones move around too much when I move my neck and it squishes nerves and such, which as you can imagine isn’t ideal.

Let’s see if I can get rid of this migraine I’ve had for literally two decades now eh?

This surgery could help all sorts of things and I’m really really hoping it does as I feel I’m close to out of options.

Wish me luck. X

[dovewithscales]

This is an important point, yeah.

I'm an anarchist and I am extremely serious when I say Jeff Bezos and everyone like him should be publicly executed

I'm also physically disabled, and grocery shopping is quite difficult for me. Especially if it entails going to multiple places. I try to shop with ethical companies where possible, but sometimes I do order from Amazon. Especially when I need something quickly but I can't go out to get it.

So I want Bezos' head on a pike, but I don't want to bring down Amazon without by some means maintaining the services it provides. It's possible for everything Amazon does to be done ethically. But that wouldn't make anyone billions of dollars.

Lately Amazon is also taking advantage of people like me who need those services, by selling second rate crap with misleading offers, and not honoring their promised shipping times. I've had medical equipment arrives a week late, and sometimes it's not even the product I actually ordered. So Amazon isn't really helping me as much anymore.

I ordered a special memory foam and gel pillow because I have atlanto-axial instability that causes severe headaches and sleep problems, and what I received was a pillow made of shredded up pieces of the type of pillow I had ordered, which was useless to me, so I'm giving it to a friend with slightly less severe neck problems who might be able to use it. But I had to wait almost a month total to get my pillow from someone else.

Basically fuck Amazon but we do need the service they say they'll offer.

being aware of the impact of things we can often not think about (like straws) is important if we’re to make strides on environmental preservation 

that does not eclipse the importance of being aware of how it impacts disabled people. they’re both conversations we need to have

[neurosurg101]

White and Panjabi checklists for spinal instability

A great reference textbook for spine biomechanics is "Clinical Biomechanics of the Spine" by White and Panjabi.

They define "clinical instability": the loss of the ability of the spine under physiologic loads to maintain its pattern of displacement so that there is no initial or additional neurological deficit, no major deformity, and no incapacitating pain.

physiologic load: are those which are incurred during normal activity -flexion, extension, axial rotation, and lateral bending- of the particular patient being evaluated incapacitating pain: pain unable to be controlled by non-narcotic drugs

White and Panjabi proposed checklists based on their biomechanical data for spine instability

Occipital-atlanto-axial complex (any point should be considered as instability)

the images below explain point in the checklist:

2. Middle and lower cervical spine:

comments on the checklist: 1) anterior elements: posterior longitudinal ligament and all structures anterior to it. 2) posterior elements: all structures behind the posterior longitudinal ligament 3) patients with anterior elements destroyed or unable to function are more clinically unstable in extension, while patients with the posterior elements destroyed or unable to function are more unstable in flexion 4) It is not assumed that the information available on all patients will provide a definitive answer for each item on the list 5) It is recommended that when the evaluation of a given element leads the clinician to a borderline decision that cannot be resolved, the value for that entity should be divided by 2 and added to the other points

positive angle = kyphotic angle (intersection anterior to spine) negative angle = lordotic angle (intersection posterior to spine)

An abnormal test is indicated by either differences of more than 1 .7 mm interspace separation or more than 7.5 degrees of change in angle between vertebrae, comparing the prestretch condition with the situation after application of axial traction equivalent to one-third body weight.

=> Examples of patients in whom one can anticipate heavy loads are heavy laborers, contact sport athletes, and avid motorcyclists

Pavlov's ratio is a reliable, accurate method for recognizing a developmentally narrow canal without the variables involved in linear measurements. The measurement A is the distance between the midlevel of the posterior aspect of the vertebral body and the nearest point on the corresponding spinolaminar line. The measurement B is seen on lateral x-ray as the anteroposterior distance from the front to the back of the vertebral body measured at the midlevel. The ratio A/B is considered normal if 1 or greater and abnormal if less than 0.8.

=> In patients under 35 years of age, post-traumatic disc narrowing is modestly suggestive of disruption of the annulus fibrosus and of possible instability.

=> A congenitally narrow canal is defined as measuring less than 1 3 mm in its anteroposterior dimension on a lateral radiograph or having a Pavlov's ratio of less than 0.8.

=> if the trauma is severe enough to cause initial neurologic damage, the support structures probably have been altered sufficiently to allow subsequent neurologic damage, and thus the situation is clinically unstable.

=> Evidence of root involvement is a weaker indicator of clinical instability. For example, a unilateral facet dislocation may cause enough foraminal encroachment to result in root symptoms and/or signs but not enough ligamentous damage to render the FSU unstable

3. Thoracic and thoracolumbar spine

4. Lumbar spine

references: (1) clinical biomechanics of spine by Augustus A. White and Manohar M. Panjabi, chapter 5

[evolutionvintage]

Yesterday we received the most amazing news. Blake has been officially cleared for AAI from the head of pediatric neurosurgery at Stanford. I love @stanfordchildrens physicians and all of the support staff. They are the best of the best in our experience. 🗣People who have children with Down Syndrome MUST have these neck x-rays done (extension, flexion, and neutral spine). If you neglect this it could have a horrific impact on your child, becoming paralyzed for example while playing or engaging in an activity like horseback riding, or anything “contact”. We first had Blake checked in 2014 when he was three. I was still stumbling though the exhausting long list of medical items to rule out or have diagnosed and treated. At that time he was in the normal range for what the doctor calls “typical” people 🙄. He is still in that range today after all of his growth. The doctor is confident that his neck is stable and he can resume all of his normal activity, participate in surf camp and ride again. When we first went I was terrified, imagining his world that is already so constricting and limited be limited further. I am an information seeker by nature and needed to know! I’m so glad we went in 2014. AAI: Atlantoaxial instability (AAI) is characterized by excessive movement at the junction between the atlas (C1) and axis (C2) as a result of either a bony or ligamentous abnormality. It is a condition that affects the bones in the upper spine or neck under the base of the skull. The joint between the upper spine and base of the skull is called the atlanto-axial joint. In people with Down syndrome, the ligaments (connections between muscles) are “lax” or floppy. This can result in AAI where the bones are less stable and can damage the spinal cord. If you’ve been putting it off get your child cleared. If you didn’t know, now you know so make the appointment! My parental public service announcement for the day 🗣🐎 🏄🏻‍♂️ 🏃🏻‍♂️ 🧗🏻‍♂️ #AAI #DownSyndrome #Parenting #Disability #momsofinstagram #parentingtip (at Stanford Children's Health - Lucile Packard Children's Hospital Stanford) https://www.instagram.com/p/CQjHib-gWw-/?utm_medium=tumblr

[hellodolly786-blog]

Best Neck Brace for Dogs - 2020 Reviews

Before getting started, the concept of a neck brace for dogs. You know we have one of the best friends on earth, and that is our dog. Just like humans, as we need a neck collar at the time of posture problems. Same, our pet dog needs full attention if having some issue on the neck. Yeah, I agree with some bloggers; it is hard to find symptoms if your dog is having a problem on the neck. Any dog may create a'sslipped disc' in their neck, though the challenge is quite uncommon in puppies within two decades old. Dogs can go from routine to getting severe neck pain in a few minutes. In reality, a dog's neck discomfort may cause them not to proceed unless or until they receive a suitable therapy. Neck braces for dogs are specially designed for your pet to provide them relief in case of cervical vertebrae, crushed nerves, neurological issues, and hernias. Additionally, it is beneficial in circumstances of obsessive-compulsive behaviors.

Symptoms of Dog Neck Pain

The neck is a string of little bones linked by ligaments and divided by thin ribs known as disks. Besides some type of traumatic injury to the neck, such as a bite wound or athletic injury, neck pain in dogs is most often brought on by a disk that slides out from place and presses on the spinal cord or among its branches. Breed plays a significant part in puppy neck pain. Small breed dogs suffer from two cerebral abnormalities of their first two neck bones. In the following 4 conditions, you can consult with VET because your dog is getting neck injury. Before the research of neck braces for Dogs, you need to know about the following symptoms that result to brace your dog. Intervertebral Disc Disease The neurosurgeon frequently must eliminate parts of the disk from all around the spinal cord. Many dogs with IVDD may handle strict cage rest, which appears to a lot of people to be preferable to operation, but I am certainly placing your puppy in a crate for 4-6 months is hard on the whole family. Atlanto-Axial Malformation It is little loss of connection between the first and second neck bone. I mostly found in small breeds of dogs. They are creating a shaky link between the skull and the first two ribs of the throat. Severe instability may result in extreme migraines and pain from the pressure to the spinal cord. Some dogs may recuperate with strict cage rest and a chin to chest neck brace; additional dogs need surgery to stabilize the neck and lessen the strain on the spinal cord. Cranial Occipital Malformation Syndrome (COMS) It is very similar to atlantoaxial malformation which we have already discussed above, COMS results in abnormal formation of bone; however, in this event, the skull bone is too little to accommodate the mind satisfactorily. It causes an accumulation of spinal fluid that places pressure on the rear of the brain and spinal cord, resulting in pain. Dog Neck braces can help to reduce the pain in this situation. Dogs with this syndrome scrape at their ears and face thought to be a result of neuropathic pain. The poster puppy for COMS is your Cavalier King Charles spaniel. However, King Charles spaniels, Brussels Griffons, Yorkshire terriers, Maltese terriers, Chihuahuas, and a plethora of others will also be prone to this disease. Not many dogs with all the skull malformation show clinical indications and neck brace for dogs can be the solution but after vet recommendations. Cervical Spondomyelopathy No wonder veterinarians predict the disease"wobbler syndrome" Large and giant breed dogs are prone to creating wobbler syndrome that's characterized by a"rickety" gait: brief and choppy from the front legs together with the hind legs held broadly apart. In wobbler puppies, two distinct mechanisms trigger throat pain and gait abnormality. Both disks between the neck bones press the spinal cord, and also the throat bones extend, causing an issue.

Features of Neck Braces for Dogs

It can be a surgery alternative and take one week to recover from acute pain Helps you to protect from future injuries Provide betters support and mobilization Neck brace for a dog helps relief the neck ligaments Speedy recovery after the neck surgery helps to reduce the pain Provide stronghold of the dog neck while jumping Betting posture while sleeping

Precautions

Well research and choose perfect brace when the dog gets neck injury or pain Take care from the upward and downward position of a dog when loading into the vehicle Take care while reaching out upstair Try to feed your dog in a perfect bowl that may not creates hurdles Try to exercise dog while neck issue Make sure you are providing the best calming bed to dog

Best Neck Braces for Dogs

Neck Brace Recommendation to Use You should keep some points in your mind before bracing your dog. For appropriate usage, the neck brace for the dog must be substituted firmly across the throat, to keep it out of the rotation. While wearing the stiff collar, your dog might obtain for walks with the collar or a tap. On a 24hour time, take out the collar 1 or 2 hrs. Neck braces for the dog not mostly recommended in dog sleeping posture but in some cases, it is recommended if the dog has only pain on the neck. As your furry friend gets got the capability to hurt the brace or hurt, we urge oversight of one's furry friend regularly after sporting the prop. Before keeping the brace on the dog neck, make sure that the neck posture pf the dog is in the perfect direction. For appropriate usage, the neck brace must be tightened firmly around the neck, to keep it from turning. While wearing the stiff collar, the puppy could be taken for walks with the collar or a tap. Bottom line It is a crucial time being a dog owner if your dog gets neck injury. Neck brace for dogs can help for inflammation and reduced the pain. Canines occupied by nature and will always work to pull the leash and, in the process will damage vital organs beneath the neck. Besides, the spinal cord comprises the nerves which control the internal body organs. Even more, the neck homes the thyroid gland responsible for the regulation of the entire system metabolism. It has been found if the dog has a neck problem then it may have back pain too. Read the full article

[clinically-chronically]

Surgery no. 11

1st Major Surgery

1st Neurosurgery

Occiput-C2 spinal fusion.

We are officially 1 week post op. And there already has been so many improvements. For once I can say that my new normal is better than my previous 'Normal'.

My gait has improved so much to the point where I no longer need to use my cane inside of my own house. My right sided weakness is nearly completely gone. My nystagmus is also almost completely gone too. My daily headaches and migraines were instantly gone. My hands are slowly growing more and more functional.

I however, have not noticed a difference in my dysautonomia or Gastroparesis/intestinal dysmotility. However, this is pretty early on yet too. So we shall see where this will take us.

My neurosurgeon said it will take about 1 year to notice the full effects of the fusion and at around 3 years for my spine to completely fuse. And yet, we already have so many improvements. I'm happy with how things are going for once.

[juniperpublishers-ttsr]

Dopplerographic Assessment of Blood Flow Parameters of Vertebral Arteries in Patients with Cervicogenic Headache Due to Arthrosis and Instability of Atlanto-Axial Junction - Juniper Publishers

Journal of Trends in Technical and Scientific Research

Abstract

Introduction: Cervicogenic Headache (CH) is a syndrome characterized by chronic hemicranial pain that is referred to the head from either bony structures or soft tissues of the neck. Factors such as:

i. Stable uncomfortable positioning of the head;

ii. Increased mobility of the upper cervical vertebrae with rotational movements;

iii. A combination of external pressure over the occipital region and mobility of the cervical vertebrae on the symptomatic side causes or strengthens the existing headache. The leading role in the formation of the central nervous system is played by the irritation of the vegetative plexus of the vertebral arteries.

Objective: Dopplerographic evaluation of blood flow parameters in vertebral arteries in patients with cervicogenic headache due to arthrosis and instability of the atlanto-axial junction.

Materials and methods: A retrospective analysis of the results of Doppler ultrasound in the 2nd and 3"1 segments of the Vertebral Artery (VA) was performed in 58 patients aged 21-38 years, who had X-ray and MRI diagnosed arthrosis and instability of the atlanto-axial junction; among the examined were 21 men and 37 women. The maximum Systolic Velocity (Vs), the end Diastolic Velocity (Vd), the Resistance Index (RI) in second and third segments of VA in the neutral spine and flexion position of the neck. The control group consisted of 27 people aged 19-36 years without chronic headache, absence of arthrosis of the atlanto-axial junction according to the results of X-ray or MRI. Dopplerography was conducted on a Philips HD 11XE device using a linear and microconvection transducers in the frequency range 5-10MHz and 4-9 MHz; MRI - General Electric, Signa HDI, 1.5T.

Results: In the control group in the second segment of the VA, Vs was 50.3±5.1cm/s, RI - 0.61±0.03; at the level of 3rd segment-48.9±5.1cm/s, RI - 0.58±0.03; at the rotation of the head - Vs 43.6±4.5cm/s, RI - 0.62±0.03, respectively. In a patients with Atlanto-axial arthrosis in the second segment of the VA, Vs was 48.9±5.3cm/s, RI-0.56±0.03; at the level of 3rd segment - 45.3±4.9cm/s, RI-0.54±0.03; at the rotation of the head- 37.2±4.1cm/c, RI-0.71±0.04 (P<0.05) respectively. In patients with atlanto-axial instability at the level of C5-C6, Vs amounted to 49.2±5.1cm/s, RI-0.59±0.03; at the level of 3-d segment of VA-Vs was 46.1±4.8cm/s, RI - 0.58±0.03. When the head was turned to the side in patients with instability of the atlanto-axial junction, Vs was significantly lower compared to the control group (34.1±4.2cm/s and 43.6±4.5cm/s; RI more then in the second segment of the VA (P<0.05).

Conclusion: Instability of atlanto-axial junction, especially in combination with arthrosis, is one of the common causes of cervicogenic headache in young people. The main pathogenetic mechanism of the onset of pain is changes in blood flow in the third segment of the vertebral arteries, especially during rotational movements.

Keywords:   Atlanto-axial junction, Dopplerography, Cervicogenic Headache, Atlanto-axial arthrosis & instability; Vertebral artery; Sedentary; Pathogenetic; Migraine features; Phonophobia

Abbreviations:  CH: Cervicogenic Headache; VA: Vertebral Artery; VD: Diastolic Velocity; RI: Resistance Index; CVMS: Cervical Vertebral Motor Segments; CHISG: Cervicogenic Headache International Study Group; NFR: Nociceptive Flexor Reflexes; VA: Vertebral Artery; RI: Resistance Index; RVAO: Rotational Vertebral Artery Occlusion

    Introduction

Cervicogenic Headache (CH) - one ofthe most common, is due to biomechanical dysfunction of the Cervical Vertebral Motor Segments (CVMS). It accounts for 15-20% of all headaches. More common in women (ratio 4: 1); occurs at any age, there is no hereditary predisposition, the course is predominantly chronic. The CH, as a rule, suffer from representatives of “sedentary” occupations, as well as those who in the process of work often have to tilt their head or work with the dropped. Factors such as:

i. Stable uncomfortable positioning of the head;

ii. Increased mobility of the upper cervical vertebrae with rotational movements;

iii. A combination of external pressure over the occipital region and mobility of the cervical vertebrae on the symptomatic side causes or strengthens the existing headache. The leading role in the formation of the central nervous system is played by the irritation of the vegetative plexus of the vertebral arteries [1].

The current version of the diagnostic criteria of the CH is presented in the International Classification of Headache- Related Disorders (1CHRD-3 beta) in paragraph 11.2.1 (Table 1). According to 1CHRD-3, CH is a headache caused by a lesion of the neck (bone structures, disc and/or soft tissues) and is usually accompanied by pain in the neck. The unilateral character of the headache without a change of sides, the provocation of a typical pattern of pain by the external pressure on the neck muscles or movement in the cervical spine, the spread of the pain from the occipital area to the front temporal allows differentiating CH from migraine and tension headache. Nevertheless, the CH may have some “migraine features”, such as nausea, vomiting, photo and phonophobia, but their intensity and severity is significantly less than with migraine [2].

The leading pathogenetic mechanism of CH development is a change in the mobility of the three upper cervical segments. The leading role in the formation of the central nervous system is played by the irritation of the vegetative plexus of the vertebral arteries. There is a significant lack of agreement in the definition of the diagnosis of cervicogenic headache [3]. The CH diagnostic criteria rely, at least in part, on a patient's response to diagnostic facet injection blocks. Controlled diagnostic blocks into the cervical facet joints are invasive, expensive and not readily available, and so they cannot be considered as useful in most practitioners' offices. Merging the International Headache Society 1HS and the Cervicogenic Headache International Study Group (CH1SG) criteria helped improve the diagnosis of cervicogenic headaches [3].

There is considerable overlap in the clinical presentations of cervicogenic, migraine and tension-type headaches, implying that many of these signs and symptoms are not unique to any particular headache type. Because of these issues, according to Hall “incorrect headache diagnosis may occur in more than 50% of cases.” Therefore, it is important that the practitioner carefully keep in mind competing diagnoses and monitor response to treatment [4].

The traditional diagnosis method of cervical spondylosis is based on X-ray reading. Based on an analysis of 1034 clinical cases and 60 cases of a test group using digital radiography [5] increased the diagnostic efficiency of up to 80% of cervical spondylosis compared with conventional radiography, which diagnosed spondylosis in 68.3% of cases [5].

Doppler ultrasound imaging is a noninvasive and useful modality for the examination of vertebral arteries. Color duplex/Doppler ultrasound is considered to provide a valid and reliable noninvasive measurement of vertebral arterial blood flow velocity. There is evidence that Doppler ultrasound measures of vertebral artery blood flow may be sufficiently responsive to detect changes in cervical rotations or after intervention. It has been reported that a decrease in vertebral artery blood flow could be identified by Doppler ultrasound at both upper and lower cervical levels during end-range cervical rotation in asymptomatic participants. This indicated that Doppler ultrasound would be able to detect changes in the vertebral arterial blood flow velocities decreased when the vertebral arteries are under stress from compression or stretching. Doppler ultrasound has also been used to detect improvement in vertebral arterial blood flow velocities in patients with vertebrobasilar artery insufficiency before and after medical intervention [5-8].

Based on the study of nictitating and nociceptive flexor reflexes (NR and NFR) in 63 patients with chronic and 40 patients with epizodic migraine, Zenkevich AS [9] concluded that in a large number of patients, neck pain is an indispensable component of the pathogenesis of chronic migraine [9].

    Objective

Dopplerographic evaluation of blood flow parameters in vertebral arteries in patients with cervicogenic headache due to arthrosis and instability of the atlanto-axial junction.

    Materials and methods

A retrospective analysis of the results of Doppler ultrasound in the 2nd and 3rd segments of the Vertebral Artery (VA) was performed in 58 patients aged 21-38 years, who had X-ray and MR1 diagnosed arthrosis (26 person) and instability (32 person) of the atlanto-axial junction; among the examined were 21 men and 37 women. The maximum Systolic Velocity (Vs), the end Diastolic Velocity (Vd), the Resistance 1ndex (R1) in second and third segments of VA in the neutral spine and flexion position of the neck were determined. The control group consisted of 27 people aged 19-36 years without chronic headache, absence of arthrosis of the atlanto-axial junction according to the results of X-ray or MRI. Dopplerography was conducted on a Philips HD 11XE device using a linear and microconvection transducers in the frequency range 5-10MHz and 4-9 MHz; MRI - General Electric, Signa HDI, 1.5T.

    Results

In all subjects, the Doppler blood flow spectrum was recorded in the second segment (at level of C4-C5), at the third (at level of lateral atlanto-axial junction) and fourth segments of vertebral artery in the neutral spine position and also with the head turning to the side. In the control group in the second segment of the VA, Vs was 50.3±5.1cm/s, RI-0.61±0.03; at the level of 3-rd segment - 48.9±5.1cm/s, RI - 0.58±0.03; at the rotation of the head - Vs 43.6±4.5cm/s, RI-0.62±0.03, respectively (Figure 1-5).

As can be seen from Table 1 in a patients with Atlanto-axial arthrosis in the second segment of the VA, Vs was 48.9±5.3cm/s, RI-0.56±0.03; at the level of 3-rd segment-45.3±4.9cm/s, RI-0.54±0.03; at the rotation of the head-37.2±4.1cm/c, RI-0. 71±0.04 respectively (Figure 6). RI in patients with arthrosis of the atlas-axial junction with rotation of the neck was significantly less than in the second segment in these patients, and VS less than in the control group (P<0,05).

Dopplerometric parameters of vertebral artery blood flow in patients with atlanto-axial instability are presented in (Table 2). In this patients at the level of C5-C6, Vs amounted to 49.2±5.1cm/s, RI-0.59±0.03; at the level of 3-d segment of VA-Vs was 46.1±4.8cm/s, RI-0.58±0.03 (Figure 7). When the head was turned to the side in patients with instability of the atlanto-axial junction, Vs was significantly lower compared to the control group (34.1±4.2cm/s and 43.6±4.5cm/s; RI more then in the second segment of the VA (P<0.05).

    Discussion

Bayrak et al. [10] studied correlations between the indices of degeneration, the positions of the cervical vertebrae and the Doppler parameters of the vertebral arteries. However, they evaluated vertebral arteries in patients with a head in a neutral position. Rotational Vertebral Artery Occlusion (RVAO), or bow hunter’s syndrome, most often occurs at the C1-C2 level on physiological head rotation. It presents with symptoms of vertebrobasilar insufficiency [11]. Yamaoka Y [12] studied the role of ultrasound in diagnosing the degree of changes in the Atlanta loop with the maximum rotation of the head.

In our study, we assessed vertebral arteries in patients with arthrosis and instability of the atlas-axial junction and healthy with a turn of the head to the contralateral side. Because the vertebral artery passes through the bony transverse foramina, it is vulnerable to stenosis with head rotation caused by compression by osteophytes. Therefore, our results suggest that with the rotation of the unstable atlanto-axial junction compression increases, causing marked luminal narrowing and reducing blood flow through the vertebral arteries.

    Conclusion

Instability of atlanto-axial junction, especially in combination with arthrosis, is one of the common causes of cervicogenic headache in young people. The main pathogenetic mechanism of the onset of pain is changes in blood flow in the third segment of the vertebral arteries, especially during rotational movements.

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[bloojayoolie]

Andrew Bogut, Animals, and Beautiful: TES pup NEEDS us NOw Pleeease HELP THIS p LuS This beautiful little lady is Tulip 53832 who was all wiggly waggly, happy go lucky sweet & friendly upon intake unil her neck was touched. That's when she YELPED IN PAIN, poor little gal: Turns out she has what appears to be a slipped disc, VERY PAINFUL. Needless to say, this little sweetheart of a girl NEEDS OUT& to a vet ASAP. PLEASE, PLEASE, get her OUT TODAY!!! She is waiting for you to save her life at the Manhattan, NY ACC. Inquire about her now before it is too late! NYC **FOSTER or ADOPTER NEEDED ASAP** NYC **THIS pup NEEDS us NOW** This beautiful little lady is Tulip 53832 who was all wiggly waggly, happy go lucky, sweet & friendly upon intake until her neck was touched. That's when she YELPED IN PAIN, poor little gal :( Turns out she has what appears to be a slipped disc, VERY PAINFUL.. Needless to say, this little sweetheart of a girl NEEDS OUT & to a vet ASAP. PLEASE, PLEASE, get her OUT TODAY!!! She is waiting for you to save her life at the Manhattan, NY ACC. Inquire about her now before it is too late! ✔Pledge✔Tag✔Share✔FOSTER✔ADOPT✔Save her life! ****************************************** To FOSTER or ADOPT, SPEAK UP NOW: Direct Adopt from the ACC Or Apply with rescues Or Message Must Love Dogs - Saving NYC Dogs for assistance ASAP!!! ****************************************** The general rule is to foster you have to be within 4 hours of the NYC ACC approved New Hope partner rescues you are applying with and to adopt you will have to be in the general NE US area; NY, NJ, CT, PA, DC, MD, DE, NH, RI, MA, VT & ME (some rescues will transport to VA) UNLESS you can get to the shelter IN PERSON. ****************************************** Tulip 53832 Small Mixed Breed Sex female Age 10 yrs (approx.) - 12 lbs My health has been checked. My vaccinations are up to date. My worming is up to date. I have been micro-chipped. I am waiting for you at the Manhattan, NY ACC. Please, Please, Please, save me! Date of intake: 31-Jan-2019 Summary: Loose and wiggly, painful lump on neck Means of surrender (length of time in previous home): Stray Behavior toward strangers: Loose and wiggly, allowed all handling Basic Information: Tulip is approximately a 10 year old small mix breed. Client stated he found her walking around in the Bronx early today. How is this dog around strangers? Tulip had a loose and wiggly body. She allowed handling. Behavior Notes: Behavior upon intake Tulip had a loose and wiggly body. Allowed counselor to scan for a microchip, pet and take a picture. Was not able to collar her due to her yelping in pain when i put the leash around her neck. JAN 31 DVM Intake Exam Estimated age: Estimated 10 years based on dentition and overall condition Microchip noted on Intake? Scanned negative History : Stray, no health hx available Subjective: Lame - difficult to tell exactly which leg. Screams in pain when touched. Observed Behavior - Tense, difficult to assess behavior due to level of pain Evidence of Cruelty seen - None Evidence of Trauma seen - No clear evidence Objective BAR-H, MMs pink and moist, BCS 4.5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: Severe tartar and mobility in both maxillary canines. Other teeth have mild tartar. PLN: No enlargements noted H/L: NSR, NMA, Lungs clear, eupnic, no coughing or sneezing ABD: Tense, difficult to assess. Not distended. U/G: Female, mature vulva, no discharge. No mammary masses. MSI: Ambulatory x 4 but possibly lame on RHL vs. RFL vs. LFL. Long fur coat, poorly groomed. Skin free of parasites. Small dermal nodule on left flank. Reported mass on right side of neck - not noted. CNS: Mentation appropriate. Pt appears extremely painful on the lightest touch or imagined touch to neck, spine, abdomen, legs. Rectal: Normal externally Assessment: 1. Severe pain to neck, spine, abdomen, legs - almost everywhere. R/O spinal disease in cervical spine such as IVDD. 2. Dental disease, mobile teeth 3. Dermal mass Plan: 1. Hydromorphone 0.3 ml IM given following exam 2. Buprenorphine 0.4 ml SQ q8 hours - 10pm, 6am and 2pm 3. Carprofen 50 mg/ml 0.5 ml SQ given following exam - then 25 mg PO SID starting tomorrow evening 4. Tomorrow, sedate for CBC/chemistry/HWT, MC placement and spinal rads SURGERY: Permanent waiver due to ageVet Notes: 1:27 PM Radiographic Review increased intervertebral space between C1-C2 with ventral displacement of C1. Remaining vertebral bodies are normal in appearance. FEB 1 Vet Notes: 1:24 PM SO QAR in kennel. Allows gentle handling but very painful on neck manipulation. Sedated for spinal rads A Suspect Atlanto axial instability P sedated with hydromorphone 0.3ml, dexdomitor 0.4ml IM reversed with 0.2ml antisedan continue with current tx plan recommend immediate placement for neurological and surgical consultation ... NOTE: *** WE HAVE NO OTHER INFORMATION THAN WHAT IS LISTED WITH THIS FLYER *** - For more information, or to direct adopt, please EMAIL adopt@nycacc.org - SUBJECT Line: ** Dogs Name & ID# ** - Don't forget to add your email address and phone numbers where they can reach you to your email as well. .... ****************************************** RE: ACC site Just because a dog is not on the ACC site does NOT necessarily mean safe. There are many reasons for this like a hold or an eval has not been conducted yet or the dog is rescue-only... the list goes on... Please, do share & apply to foster/adopt these pups as well until their thread is updated with their most current status. TY! ======== Shelter addresses ====== - Manhattan Shelter: 326 East 110 St., New York, NY 10029 - Brooklyn Shelter: 2336 Linden Boulevard, Brooklyn, NY 11208 - Staten Island: 3139 Veterans Rd W, Staten Island, NY 10309 - Phone number: 212-788-4000 (is automated only) Operating hours: Monday through Friday 12.00pm to 8.00pm, Saturday & Sunday: 10.00am to 6.00pm. Closed on all Holidays. ****************************************** About Must Love Dogs - Saving NYC Dogs: We are a group of advocates (NOT a shelter NOR a rescue group) dedicated to finding loving homes for NYC dogs in desperate need. ALL the dogs on our site need Rescue, Fosters, or Adopters & that ASAP as they are in NYC high-kill shelters. If you cannot foster or adopt, please share them far & wide. Thank you for caring!! <3 ****************************************** RESCUES: * Indicates New Hope Rescue partner is accepting applications for fosters and/or adopters. http://www.nycacc.org/get-involved/new-hope/nhpartners ****************************************** ++++ https://nycaccpets.shelterbuddy.com/animal/animalDetails.asp?task=search&advanced=1&rspca_id=53832&animalType=1%2C2%2C15%2C3%2C16%2C15%2C16%2C86%2C79&datelostfoundmonth=1&datelostfoundday=1&datelostfoundyear=2019&find-submitbtn=Find+Animals&tpage=1&searchType=2&animalid=91744 ++++ ++++ Beamer Maximillian Caro Hocker Carolin Hocker Jody Harris-Stern Judy Iannone Vicenzo Jennifer Brooks Jackie O'Sullivan Anarchy Animal Rescue & Rehabilitation Beastly Rescue, Inc.

[kinkykinard]

Dealt with a traumatic atlanto-axial instability at work today.

I get to check another type of injury off of my trauma bingo card.

[monchiropracteur]

Apparent diffusion coefficient as an indicator of spinal cord compression due to anterior atlanto-axial subluxation in rheumatoid arthritis patients

http://monchiropracteur.com/ monchiropracteur.com Abstract Purpose The aim of this retrospective study was to evaluate the apparent diffusion coefficient (ADC) as a potential parameter of spinal cord damage in cervical spine instability at the atlanto-axial level in rheumatoid arthritis (RA) patients. Methods One hundred and six RA patients were included in the study. MRI examinations were performed with 1.5T scanner. The ADC was measured at six locations in the cervical spinal cord at the height of the first six cervical vertebrae (from C-1 to C-6). The ADC values were assessed in 2 groups: with and without anterior atlanto-axial subluxation (AAS) diagnosed on plain radiographs. Correlations between ADC values and radiographic measurements and RA activity indicators were evaluated. Results The ADC values at C1 level (ADC1) was higher in the group with anterior AAS than in the group without AAS (p  http://link.springer.com/10.1007/s00586-019-06058-2?utm_source=dlvr.it&utm_medium=tumblr http://monchiropracteur.com/

[angelojocd198-blog]

Back Discomfort, Neck Pain, Sciatica - Chiropractor Castle Hill Three Alternative Considerations

There is a lot of buzz around social media nowadays. As a chiropractic specialist, you have actually probably heard different consultants out there applauding the virtues of Twitter and facebook as opportunities to get massive exposure and draw in brand-new clients.

What Chiropractic Practitioner Treatments Are There?

You are forced to believe about what you understand when you teach. to crystallize your understanding. to address your unanswered questions. You get questions tossed back at you. and this really internalizes the knowledge. So let's see how this could use to the average person in service. For instance, if you're a chiropractor or health practitioner. Here's what I would do to execute the "teach to find out" concept and turn it into a profit. I 'd begin a regular newsletter.

These comments and concerns typically are joked about when taking in factor to consider all that's needed to build an effective practice. Even worse yet, if we are not really cautious, this kind of state of mind can be a road to an owner medical professionals practice downslide, ultimate failure and considerable stress and misery.

10 Tips To Avoid Neck And Back Pain This Christmas

Unfavorable: Your cholesterol is really high, if you don't diet, the odds of getting heart disease will increase and nobody will be left to take care of your kids. Your household has a history of heart problem so you need to know. You much better take this pill to reduce your cholesterol.

I have fantastic success dealing with people with head injuries and concussions with specific Chiropractic adjustments to the occipito-atlantal or atlanto-axial joint and soft tissue treatments. When appropriate movement and functions are brought back to the ligaments, joints and muscles, specific rehabilitation workouts start.

Seattle, Bruce Lee, And Chiropractic History

It is a good idea to look for the suggestions of a health professional following a sports injury. This is specifically true if the injury triggers severe pain, swelling or pins and needles or joint instability. It should likewise be thought about if you can not tolerate weight on the injured location or if the signs are not disappearing.

Chiropractic And Leg And Hip Pain

Chiropractic care frees the old people from all their pain, which cause them to suffer needlessly. With the various https://manuelpeqp714.skyrock.com/3323128508-Persistent-Neck-And-Back-Pain-Relief-Chiropractor-in-Castle-Hill-3.html benefits offered by chiropractic, they can still take pleasure in life and be independent. Bring him to a chiropractor if any of your grandparents suffer from pain. Do not let them suffer.

[sciphishow]

Submission Call for Charity Anthology: Impossible Hope

Submission Call for Charity Anthology: Impossible Hope

For six years, Bonnie Oliver has gone from doctor to doctor seeking answers for her physical and neurological symptoms, finding no help while her condition worsened to the point where she could not leave her home unaided, and even then for only short periods of time. Finally in 2018, she got some answers: Complex Chiari Malformation, Craniocervical and Atlanto-axial Instability and Ehlers-Danlos…

[clinically-chronically]

1 month until spinal fusion day!! We are getting closer everyone!