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Advanced Imaging & Chiropractic

CBCT, Chiropractic, upper cervical

Posterior view of the upper cervical region.

Here is a recent publication from the Journal of Upper Cervical Chiropractic Research by researchers Dr. Jonathan Verderame and Dr. Jake Hollowell. What makes this article impressive is that the patient was evaluated using the cone beam CT (CBCT) technology in a chiropractic setting. This is really unique and, as the article states, “the utilization of CBCT in a clinical chiropractic setting has not been explored.”

While CT is said to be an ‘extremely valuable tool’ that is a ‘widely available noninvasive modality for evaluating abnormalities of the spine’ it has never been used for bio-mechanical assessment of the occipital-atlanto-axial misalignment for chiropractic analysis.

The intervention that was provided to a 75-year-old patient that suffered from chronic migraines was a specialty in chiropractic known as Blair Upper Cervical Technique, or Blair for short. Traditionally this method of chiropractic requires various x-ray images to evaluate the structure and mechanics that are involved in the upper cervical region of the spine. With the CBCT technology, a chiropractor will not only be able to assess the alignment of the vertebrae but also be able to identify small and significant congenital or acquired anomalies that may effect the clinical recommendations of the patient.

CBCT unit by Scanora

CBCT unit by Scanora

This is a fairly new and highly specialized field in chiropractic. The CBCT is more commonly found in a dentist or orthodontist office and used to evaluate structures of the jaw and teeth. While traditional chiropractic care is excellent in caring for migraines and headaches, the research confirmed that the patient only needed two corrections in the 10 week evaluation period.  The use of such equipment in chiropractic specialties has implications that a patient may see greater improvement with less interventions. There is a potential to reach individuals with more complex conditions.

The article address the risk of radiation and states that the CBCT uses “between 98.5% and 76.2% [less radiation] compared to traditional CT.” The way this is done is by “pulsing” the radiation so the patient is not subject to it during the whole procedure. With reduced exposure to radiation and improved image for evaluation, this modality for examining the spine may prove useful in certain cases.

The drawbacks might include the cost to both the practitioner and the patient, specialized training in the use of the imaging software and patient exposure to radiation. As with everything, there’s a risk vs benefit factor.

Read full article

Reference

  • Verderame, Johnathan and Hollowell, Jake. “Cone-beam Computerized Tomography for the Bio-mechanical Assessment of the Occipito-atlanto-axial Articulation in a 75-year-old Woman with Migraines Undergoing Blair Technique” Journal of Upper Cervical Chiropractic Research. July 2013.
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A Case For Improved Headache Evaluation

Several causes of headaches relate to the alignment of the first two bones of the neck.

Headaches, in general terms, lie on a spectrum from an occasional annoyance to debilitating and causing loss time at work and enjoying family. Headaches come in all shapes and sizes and so do the treatments. There have been studies demonstrating the effectiveness of many types of treatments.

First off, we need to agree that a normal headache does not exist. Headaches are alarms telling you that something is amiss in your body. This could be as subtle as not drinking enough water to experiencing a stroke. If you have headaches, even if they are just occasional, understand that this is not a normal function of the body.

In the study published in the “Headache: The Journal of  Head and Face Pain” on chronic headache due to hypertonic muscles that attach to the dura matter, a surgical intervention was performed to sever the muscles from the spinal cord. The article explains a normally occurring muscle in the sub-occipital region attaches to the spinal cord. The patient, 35 year old male, had a traumatic incident and subsequent tightness of this muscle putting tension and distortion on the spinal cord/brainstem and causing symptoms of a headache. It was noted that since the incident, the patient had developed a poor immune response as evidenced by the frequency of respiratory and intestinal infection.

The intervention was to surgically sever the tight muscle in hopes that this would relieve the tension and torsion on the spinal cord/brainstem and decrease the severity of the headaches. While the intervention was successful in the sense that the muscle was severed and the patient recovered from surgery, the headaches lessened only in intensity, not in frequency. Common side effects of such procedures are described as “post operative headaches”.

The patient’s complaint persists and is a failure on the part of the exam doctor to understand the anatomy and the mechanics involved. The other attachments of this muscle are on the back of the skull and the first bone in the neck – Atlas. It is very probable and likely that during the traumatic incident that the Atlas became misaligned and torqued, a condition called an upper cervical subluxation, pulling on the muscle and various other structures causing distortion of the spinal cord/brainstem. This is evidenced by several features common in an upper cervical subluxation: sudden onset of headaches following a traumatic incident, tight sub-occipital muscles due to misalignment of bone structures, decreased immune response owed to reduced communication of the brain to the body.

Various structures are affected by an upper cervical subluxation.

This is further demonstrated by a failure to only partially reduce the symptoms of a headache. The procedure eliminated one instigating agent but did not address the various other factors of an upper cervical subluxation, so the patient would not be able to fully heal. There is so much happening at this location with skeletal, ligamentous and muscular tissue not to mention the nervous tissue that carries body intelligence to every part of your body. An appropriate evaluation of this area is essential to proper treatment of upper cervical subluxation for the best patient care.

Effective upper cervical care can be accomplished and thousands of patients have been helped by removing the causative agent of many types of headaches. This is done without exposing the patient to chemical drugs, surgery, or other lengthy procedures. Not only do the symptoms subside, the effect is realized throughout the entire body improving the immense response and decreasing blood pressure in many cases. Headaches do not need to interfere with your quality of life. Check out the links on the right for other research and testimonies of patients with headaches and become informed of your treatment options.

Another popular management option that does not address the cause of the symptoms is medication. Medication may silence the symptoms, but the inciting problem persists and you can expect the symptoms to return. The liver and kidneys take the brunt of the effects of the medication and there are almost always negative events in response to these chemicals.

Again there is no such thing as a normal headache. Turning off the alarm without addressing the fire will only result in ashes.

Natural Treatment for Hypertension

5 April 2012 1 comment

As I started to read an article on hypertension and upper cervical care from the Journal of Human Hypertension, the very first sentence of the abstract struck me as eye opening and I re-read it to absorb it meaning. “Anatomical abnormalities of the cervical spine … associated with relative ischaemia of the brainstem circulation…” What?! I knew that blood pressure is commonly decreased with upper cervical care but I had no idea ischemia or inadequate blood flow was taking place – at the brainstem no less. If there is and part of your body that you want continuous blood flow to, it’s your brain.

Lets look at the anatomy involved:

So how does a misalignment cause increased blood pressure? I am not 100% sure and the study was not helpful in discovering an exact explanation. The study did hypothesis that there would be a concurrent drop in heart rate with the correction of the misalignment which was not the case. If this had occurred, then that would lead to suspicion of sympathetic involvement and blood vessel control. There may yet be a neurological component but it is clear that a mechanical decrease of blood flow is possible with the tortuous path of the vertebral artery and all the dynamic anatomy surrounding it.

The presentation of this study, albeit small sample size(n=50), follows the traditional methodology of medical research, double blind and use of a placebo group. During the study no hypertensive medication was taken by either group. The intervention included a NUCCA evaluation (described in the article) and NUCCA adjustment of the Atlas vertebra. The outcome was that the treatment group had a decrease in systolic blood pressure by more than 13 points and a 7 point drop in diastolic blood pressure.

Interestingly, the criteria for a new antihypertensive drug to be cleared by the FDA is that it lowers diastolic blood pressure by at least 5mmHg and free of serious side effects. This part sums up the application of this research in a nutshell:

“The improvement in BP following the correction of Atlas misalignment is similar to that seen by giving two different antihypertensive agents simultaneously. Moreover, this reduction in BP persisted at 8 weeks and was not associated with pain or pain relief or any other symptom that could be associated with a rise in BP.”

Some related studies show that 90.6% of people that suffer hypertension have compression of the vertebral artery at the level of Atlas. This is an option for anyone that is hypertensive or even borderline hypertensive to help regulate your blood pressure and health.

Other natural consideration in addition to upper cervical care that have shown to help decrease blood pressure are: exercise, improve quality of diet, fish oil supplement, weight loss, decrease stress and avoid tobacco & alcohol.

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