![]() We cannot get enough information to assess instability. In that scenario, people will not allow the neck to flex or extend. Sometimes, people have severe neck stiffness and pain, with spasms. There is a problem, however with flexion-extension x-rays. Continued neck pain should be evaluated for instability. People with Rheumatoid arthritis have risks of developing instability secondary to the auto immune effects. Patients who have had a recent trauma, with concerns of disruption of the liagments and supporting structures in the neck.ģ. And, as discussed above, criterion for rotatory instability has not been established.Ģ. But, now that we know there is a certain radiation risk to CT scans, I do not know if the risks for the scan will justify the test for rotational instability. ![]() In theory, we can have baseline CT scans of the neck, then as the person to rotate the neck to see if there is excessive facet subluxation on rotation identified by the CT scan. Unfortunately, we do not have good established criterion on how to define a rotational instability, and we do not have a good test, that does not subject you to significant radiation dosing. In patients with chronic neck pain, who describe increasing pains with specific motions, flexion-extension x-rays can help define the instability.Īs a side issue, I am sure there a some patients that become instable with rotation as well. Then, let’s assume these people have already had the usual initial treatments such as physical therapy, chiropractic care, and medications.ġ. So, the question becomes, when should we suspect a cervical instability? First, lets assume these people have already been worked up to make sure there is no fracture, tumor, infection or significant disk herniation. Instability is established by a angulation of greater than 11.5 degrees on comparison flexion-extension. When the neck bends forward or is in flexion, the end plates are essentially parallel. When the disk space angles are measured, it opens to 14.6 degrees. In the above images, we can see that when the neck extends, the disk space opens. On comparison flexion-extension x-rays, instability can manifest by excessive “fishmouthing” of the disk space. In these same X-rays, we identify another known criterion for cervical instability. The accepted criterion for cervical instability includes a motion of greater than 3.5 mm’s. But, with extension, there is a 4.3 mm movement of the C6 body posterior (towards the back) to the C7 body. On Flexion, the posterior corners of the vertebral bodies line up. The VMA motion imaging technology is a true game-changer! Your spine deserves the latest in imaging technology.In this x-ray series, it demonstrates movement of the vertebral body of C6 on C7. It providse more accurate motion measurements to help surgeons in diagnosing your unique condition, which lead to surgeons choosing better treatment options. The VMA offers a new diagnostic tool that provides additional imaging data to surgeons, which may help him/her to locate the source of your spinal issues. VMA represents the future of functional spine imaging.įrisco Spine is excited about being one of the first in the region to offer this new Spine Motion Imaging option. One of the major advantages of this technology is that the radiation dose is lower than what the patient would be exposed to with a standard six view x-ray series, which has been the standard until now. This technology has been proven to be more sensitive and reproducible in determining instability requiring surgical fusion. This analysis is read by a Board Certified Diagnostic Radiologist and provided to the surgeon who can reliably make decisions about the need for surgery based on whether the spinal bones remained properly aligned with motion. VMA Imaging Technology – The most advanced spine in motion imaging technology, Vertebral Motion Analysis X-ray devices.Īn advanced software analysis of the motion is then performed highlighting any levels of instability.
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