Two questions regarding findings on CT C-spine

by Suzanne
(Ohio )

1. Can any of the following CT findings be caused by a traumatic SCI?
a. Hypertrophy of the uncovertebral joints causing encroachment of the neural foramina at multiple levels.
b. Moderate to severe spine canal stenosis at C5-C6 level.
c. Discrete component of rotatory subluxation between C1 and C2.

2. Can any of the above findings cause paralysis?

Hello Suzanne,
Can you give me more details of the case. How old is the patient, when did the trauma occur, and is there old trauma too.

Where is this paralysis and how severe is it? Giving me as much detail as you can will enable to give me a more relevant reply to your questions.

Kind regards,

Dr B

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Apr 21, 2017
by: Suzanne

The injury was sustained falling from a standing position thinking he hit his face/head on a milk crate as he had a broken nose and bleeding from his nose as well as pericardial contusions.

Docs here are thinking it was a possible hyperextension/flexion injury. It is regarding my brother who is 68. He was totally normal prior to his fall, living independently. He had no previous issues, but I'm sure he had the age-related degenerative changes.

He went to a trauma center and those were the findings. The accident happened 2/29/16. He is total quad, had some movement of right arm until he became severely contracted, and now has severe stage IV/unstageable pressure ulcers, both hips to bone as well as sacrum.

Over the past year, I have joined a few SCI online groups as well as receiving information and talking with a peer mentor through the Christopher and Dana Reeves Foundation to learn more about his injury. I was doing some research the other night and ran across your site. Let me tell you, that site is amazingly informative! I've shared it numerous times already. I was hoping someone could shed some light on those CT scans, as the physicians here in our rural community are very ... well not sure what to say! Thank you for responding so promptly!!

Hello again Suzanne,
Seeing that your brother is a total quad we know the spinal cord injury was somewhere in the neck; it's highly likely that it aggravated a very old injury that caused spinal stenosis in his mid cervical spine; that's narrowing of the canal that the spinal cord traverses.

Has you brother had any cervical traction? You can get a relatively inexpensive device that will stretch out the neck at home. That's my only suggestion I'm afraid. I think it unlikely that chiropractic would have much of a contribution to make.

I wish I could be more positive; such a seemingly innocuous spill having such disastrous results. Life can be very tough.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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