Digital Motion X-Ray for diagnosing Neck Instability
One of the primary areas of the body that we specialize in treating is the neck, or cervical spine. Often this is triggered from a sudden accident such as whiplash injury or post-concussion syndrome, but can also be due to short stresses on the cervical spine over a long period of time, such as overmanipulation, and extended hours of poor posture from computer usage.
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While headaches and neck pain are usually the top patient complaints, the related symptoms that can be triggered by cervical instability are extensive. These can include facial numbness, vertigo, dizziness, tinnitus (ringing in the ears), burning sensations, fatigue, racing heart, exhaustion, weakness, pressure in the sinuses and behind the eyes, and others.
These can lead to depression, anxiety, irritability, and memory problems which lead to difficulties at home and work, often while the patient searches relentlessly for answers–Digital Motion X-ray (DMX) can often provide the doctor and patient the answers to these strange clusters of symptoms.
DMX is a motion picture of the bones while a person is moving. In this video, you can see Dr. Ross Hauser’s Digital Motion X-ray taken in 2011, taken during an episode of cervical radiculopathy (pinched nerve) down his right arm. As you can see from the DMX when he extended my neck the neural foramina closed at multiple levels, thus compressing the nerve roots and causing symptoms.
In his own words “When I was stationary or flexing my neck I was fine, as the nerve root had plenty of room within the neural foramina but when I extended my neck, the space closed and the pain went zinging down my arm.” The space narrowed because the ligaments holding the adjacent vertebrae at the facet joints were injured. This is called spinal instability. After three Prolotherapy treatments, he was fine and was able to get back to cycling, running and swimming.
Again, in his own words, “What would have happened if I had chosen a decompressive surgery to open up the space? Would it have made my spine more stable or less stable? By removing bone to open up the space I would have made my spine less stable, so my situation would have been worse than at the beginning. For six months or a year I may have felt better. But then as put more and more strain on my spine due to my work and sports/workouts, the pain would have started back and most likely would have been worse than before the surgery! Why? Because my spinal instability would have been made worse with the surgery.”
Why is cervical spine surgery so popular?
If a person does not know about DMX or Prolotherapy and goes to a surgeon, he or she may be told that the space is narrowed and the surgeon would like to go in and open it up. To the uneducated person this sounds fine but what they wouldn’t realize is the real issue is not necessarily a space issue, as if there was a disc herniation narrowing the space or a big bone spur. Rather, this was a connection issue. Remember, ligaments are the connectors of one bone to another. One of the best explanations to understand this concept would be two kitchen cabinet doors that start hitting in the middle. Why do the doors start hitting? It is because the door is suddenly too big, or is it because the hinge is loose? The hinge is loose. So, what is the solution when your kitchen cabinet doors are loose? Shave the doors so they don’t hit? Replace the doors? No! The solution is to get a screwdriver and tighten the screws on the hinge! Often you find out the other hinges that hold the door are becoming loose and also need tightening. Back to the spine… After seeing the looseness in the cervical spine, DMX can prove that Prolotherapy would be the treatment of choice in order to prevent further degeneration, bone spurs, and alleviate cervical instability and its debilitating symptoms. DMX can confirm the diagnosis of joint instability and even better, document the return of stability with Prolotherapy.
My MRI shows degenerated discs do I need a DMX?
The issue of whether or not to get a DMX is one that is made between a patient and their personal physician. There are Prolotherapists that will do Prolotherapy on a patient just from the history and physical examination. There are reasons they do this including: likelihood of improvement (if based on history and physical examination the person is highly likely to get better with Prolotherapy, then additional radiographic testing is not generally necessary); already known pathology – if the MRI pathology is consistent with the history and physical examination then additional radiography including DMX is not necessary; poor outcome – if the history and physical examination reveal that Prolotherapy is not the recommended treatment then again the person is referred to the surgeon or other clinician versus getting a DMX. When the prognosis or outcome could be improved upon after the history and physical examination, then a DMX will likely be ordered.
- Ross Hauser, MD | Danielle Steilen-Matias, PA-C | Katherine Worsnick, PA-C | David Woznica, MD