Is a Torn Alar ligament bad?

///Is a Torn Alar ligament bad?
Is a Torn Alar ligament bad?
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  • Avatarmedicalgen
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    Post count: 11

    Just to add to this Dr Coreman, if Lincoln is having continuous headaches as he states, then he needs to look at the scanning of the ccj region to rule out the possibility of any cerebellar tonsillar descent and abnormal clivo-axial angle.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6985

    The Fonar scanners tend to be less sensitive than standard scanners. This is due to two reasons. One is magnet strength. The MRI is judged by magnet strength. The higher the strength, the better the resolution of the images. A standard magnet is 1.5 Tesla. Better ones are 3.0 Tesla. The Fonar magnet is 0.7 Tesla. You can see that this MRI is less sensitive than the standard MRI magnet.

    The other issue is movement. A standing (sitting) MRI inherently allows more movement than a lying down (supine) MRI. This movement causes a blur type effect like the old American wild-west pictures where a person who moves looks like a ghost on the picture.

    Cerebellar tonsil descent or Arnold Chiari Syndrome (type 1) can be easily seen on a standard MRI. The alar and dentate ligaments can also be seen. A changed clivo-axial angle would be consistent with possible upper cervical trauma, Rheumatoid arthritis or basilar invagination and can also be seen on a focused upper cervical MRI.

    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

    Thank you so much for your time Dr Corenman, though I’m not judging the magnet strength. Neither am I a specialist, but it is a fact that I had unremarkable results from both standard suppine MRI neck and brain scans, yet with the Fonar upright MRI scan my injuries were detected. This leads me to the conclusion that either the upright scanners are far more superior in detecting these injuries or sadly that the NHS radiologists can’t do their job. Kind regards Karen

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6985

    Other than the much less detailed images produced by the Fonar system. I have seen three cases just like yours that were diagnosed with upper cervical ligament changes using the Fonar system. In all cases, these individuals were eventually found not to have the findings of alar and dentate ligament injury that they were previously diagnosed. This is why I would be quite careful in depending on the Fonar images to diagnose these injuries.

    I understand you are looking for answers but I must ask you to be careful using certain technologies for diagnosis.

    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

    Thank you. I also have asymmetric rotation at the atlanto-axial articulation, (increased rotation on the contralateral side) which is suggestive of this injury also. I suppose the Fonar upright MRI scan has got this wrong too.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6985

    Asymmetric rotation certainly could be from alar ligament injury but also could be from facet capsular injury which is more common. You cannot test for alar ligament injury but you can test for capsular pain. A facet block of C1-2 with diagnostic results (see pain diary) will be diagnostic.

    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.
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