Is a Torn Alar ligament bad?

///Is a Torn Alar ligament bad?
Is a Torn Alar ligament bad?
Viewing 6 posts - 1 through 6 (of 24 total)
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  • AvatarLincoln…
    Participant
    Post count: 1

    Hi Doctor Coleman. So I got in a really high energy head on collision 2 1/2 years ago. It was my pick up truck vs. a fully loaded logging truck.

    I have had ongoing problems with neck pain and headaches which are mostly at the base of the skull, vision problems, pulsating and tingling all, over crunchy noises, vertigo, bla bla bla, I’m sure you have heard it all before.

    My doctor has blamed everything on chronic pain and wants me to find Jesus and live like a monk and it might not seem so bad. My X-rays, brain ct, mri brain and spine all clear.

    I have finally seen a competent physio therapist and he gave me the cervical ligament stress tests for my transvers and my alar ligaments. When he did the one for my Alar on the left side it felt like he was lifting my head off my body. He said that my left alar may be sublaxed or completely torn. And said I need to talk to my doctor about getting an mri of the ligament itself, and ask for a consult to a neurosurgeon about a possible spinal fusion.

    I have spoken to 3 different G.P’s and none have even heard of such an injury. I also have seen a neurologist, who said the guy is wrong and I’m fine. None of them say I need an mri or need even look any further into it. I’m mad because I want to get on with my life, and if there is a way to make me feel better I want that option.

    Can you tear your alar ligament? If it is torn is that bad? What should I do?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6759

    First is the fact there is no reliable physical examination test to determine alar ligament injury. Chronic base of the skull pain could occur from a number of different problems from arthritis of the upper facets to a C2-3 disc herniation. Alar ligament injury would be way down the list for differential diagnosis. The injury that your physical therapist alludes to does exist but it is very rare.

    General practitioners have such a burden trying to keep up with information regarding the entire body that they cannot be expected to be experts on the upper cervical spine.

    I think that chronic upper neck pain that has not resolved in 2 1/2 years deserves a workup. An MRI would be warranted as well as x-rays including flexion/extension views. A consultation with a spine surgeon or neurosurgeon would be appropriate.

    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.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Avatarmedicalgen
    Participant
    Post count: 11

    Hi Lincoln. Yes there is something you can do. Get an upright functional MRI scan. I have suffered for three years with the same problems/symptoms and have the proof: a torn left alar ligament, substantially thinned transverse ligaments and also an abnormal clivo-axial angle. These injurys can cause nerological deterioration. If you have suffered so long, you are not going to get any better. There are specialists out there in the field that have the knowledge to help you. Anyone who says it is psychomatic is ignorant of the facts.

    Avatarmedicalgen
    Participant
    Post count: 11

    Lincoln, I have seen three neurologists all a complete waste of time. I had my upright MRI scan done in London at Medserina. on

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6759

    I would very much disagree with your analysis. An upright MRI is a much poorer quality examination as there is patient motion and the strength of the magnet is about 0.7 tesla, much below the state of the art 3.0 magnets. The ability to visualize 1-2mm ligaments is obviously very limited.

    I would agree that upper neck pain generally has a cause but this type of ligament injury is very rare and generally not the cause of upper neck pain.

    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.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Avatarmedicalgen
    Participant
    Post count: 11

    The upright MRI fonar scanners detect what our standard NHS scans don’t. Yes they are more sensitive, they have to be. I have obvious injuries and consequential neurological symptoms Dr Coreman. This scan proves it. I was told I was imagining my symptoms because of previous unremarkable scan results.I’m sorry but I think you need to do a bit of research, you are not giving your readers the up to date information they need to assist them in getting a diagnosis.

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