Flexion and Extension X-RAY results !!

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  • appleannie
    Participant
    Post count: 50

    Hello Dr.corenman, I was told by my Orthopedic spine Specialist that I’M not “Unstable” at my C4-5 level anymore because of the Auto fusion That I have at C5-6 level so I asked him if it’s okay to see a Chiropractor for adjustments and he told me yes.Dr. Corenman so I made an appointment with the Chiropractor and after he examed me,he would not do any adjustments on me and this is what he said in his Report:

    There are residual effects that this patient will incur over time do to the ligament laxity damage that was directly related to the trauma on 8/09/1988. The Anterior Longitudinal ligament (ALL) and with the Posterior Longitudinal ligament (PLL) in the cervical spine have a primary responsibility to stabilize the Anterior and Posterior movement of the vertebrae.Since both the (ALL) and the (PLL) are damaged there is excessive Translation and Angulation which can be viewed in the Biomechanical Report which was analyzed on 6/28/2017 from cervical stress views which were taken on 6/09/2017. These two parameters are measured through an analysis called lines. of measuration which objectively isolates and quantifies ligament laxity in stress views (Flexion/Extension).

    Lateral Cervical Spine:
    There’s a Spondylolisthesis at C4-5.Interruption of George’s line at C2-3,C3-4,C4-5,and C5-6 during the lateral stress views (flexion/Extension) are indicative of Ligamemtous Instability.

    Cervical study: Alteration of motion segment

    :The Angular motion segment integrity appears to be compromised and Ratable at C3-4, C4-5 and C5-6.

    :The The Translational motion segment integrity appears to be compromised and Ratable at C4-5.

    IMPRESSIONS:

    1) Cervical motion study (C2-C7) indicates Angular motion segment integrity change at C3-4,C4-5 and C5-6. The impairment of the cervical region is due to Ratable loss of motion segment integrity and is Ratable at 23% for cervical spine (AMA Guides,sixth Edition) This patient’s digital analysis reveals loss of motion integrity in Flexion at C3-4=30.45, C4-5=29.39, and C5-6=11.77 and in Extension at C3-4=21.72, and C5-6- 16.10(Calculated Angulation) degrees yielding an impairment estimate based on plain film forensic at 23% whole person.
    Cervical motion study (C2-C7) indicates Translational motion segment integrity change at C4-5.The impairment of the cervical region is due to Ratable loss of motion segment integrity and is Ratable at 23% for the cervical spine (AMA Guides edition) This patient digital analysis revals loss of motion integrity at C4-5=4.04mm (total Translation)

    2) Ligamemtous Instability is suggested in the cervical spine.

    3) Interruptions of George’s line at C2-3, C4-5,and C5-6 during the lateral stress views (flexion/Extension) are indicative of Ligamemtous Instability,sub-failure or insufficiency from the evaluation of Translational motion.

    Dr.Corenman could you please explain all this Chiropractor talk to me and let me know what he is saying about my cervical spine especially at C4-5 is my cervical spine in bad shape according to the Chiropractor ??
    Please Help me understand what he is saying !! Thank You !!

    appleannie
    Participant
    Post count: 50

    Hello Dr.Corenman, I have a question about the pinsites area from the Halo brace I had to wear for three months. Dr.Corenman every time it rains or it’s damp or cold outside the area around the pinsites gets very painful could I have arthritis at the pinsites area ? Any help would be greatly appreciated. Thank You !!

    Dr. Corenman
    Moderator
    Post count: 5374

    First, the lack of stability generally results from facet wear (degenerative spondylolisthesis) and rarely results from ALL or PLL ligament tearing. Even with disc rupture, there has to be facet failure (fracture or degenerative wear) to allow forward slip of one cervical vertebra on the next. I am confused as to why your spine specialist thinks that C5-6 severe degeneration (IDR) will cause stability of your C4-5 level as this makes no sense and I believe that you might be confused by his explanation.

    instability is measured by millimeters of sliding motion and your report by the chiropractor does give values in millimeters of about 4mm motion so this level could be considered unstable. Stability is considered relative so in certain contexts, this might be a stable condition even with the slip.

    Pins from a halo do not enter a joint (the skull) so these pin sites cannot develop arthritis. Nonetheless, you can get pain from adhesions just under the skin that can exacerbate with weather. Since these adhesions are just under the skin, you can use your fingers to mobilize the connective tissue underneath to “stretch” the adhesions.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
    If this forum has helped you, please let Dr. Corenman know!

    appleannie
    Participant
    Post count: 50

    Hi Dr.Corenman,
    I’M not confused on what my Spine Doctor told me,this is exactly what he told me word for word in the Doctor Report: The patient has gone on to an Auto fusion at C5-C6 and at this point I do not consider the patient to be “Unstable”.

    Dr.Corenman this is what he told me in his office and what he said in the Doctor Report.He also told me that I don’t have any limitations and I can resume my normal activities.I’m still a little wary about my C4-5 level and I kept asking him over and over again if he is sure that I’m not unstable anymore and he resured me that I’m not.I also asked him if he meant that I was not unstable at C5-C6 level because of the Auto fusion and he said no you’re not unstable at any level of your cervical spine, because of the Auto fusion and it’s strong enough to stabilize your cervical spine.

    Thank You !!

    Dr. Corenman
    Moderator
    Post count: 5374

    I think your spine surgeon was confused as an auto-fusion (if really present at C5-6) confirms no immunity of the C4-5 level and in fact, makes C4-5 just a little bit more susceptible to injury. Maybe another opinion should be considered.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
    If this forum has helped you, please let Dr. Corenman know!

    appleannie
    Participant
    Post count: 50

    Hello Dr.Corenman,
    Thank You !! Dr.Corenman are you offering, lol

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