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Adequately covered are CSF dynamics and some aspects of ligamentous alterations at the C 1 level. In many areas of this book, one gets the strong impression that this is an unabashed endorsement for upright MR not particularly surprising given the affiliations of the 2 editors.


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Some material is out of place in a book with this title, for instance, chronic traumatic encephalopathy, posttraumatic stress, and NPH. Some of the legends related to the ligaments of the C 1 —C 2 level could be questioned, not only because of the relatively mediocre image quality but because the reader is not told the MR parameters.

The book delivers far less than the title would imply and is conjectural in ascribing symptoms to malignments written by 2 chiropractic physicians.

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Therefore, this book is not recommended as a purchase by a neuroradiologist. If you have ever seen one of my alar-accessory ligament damage addendums, or if you have been to my seminar and seen my presentation on alar and accessory ligament damage, you know that I present compelling evidence from the literature which supports why I say what I do about these ligaments- that lateral overhang of C1 on C2 is definitely abnormal.

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He said that he thought that cervical DMX studies were overused and over-read. But I have learned a whole lot about the field of motion x-ray since then, and the fact of the matter is that he is wrong when it comes to the importance of alar and accessory ligament damage when it comes to car crash cases.

Besides the fact that the literature is loaded with articles attesting to the problems associated with alar ligament damage, a new book just became available within the past month which makes the strongest statements I have ever seen about the nature of the alar ligament lesions, and also addresses solutions for the problem. Smith, PhD, and Jay S.

Dworkin, MD. Of particular interest to me is the second chapter because it was authored by Joel Franck, MD, the prominent Panama City, FL, neurosurgeon, who has come up with a minimally invasive for surgery , novel way to repair the damage to the C1-C2 level.

The Craniocervical Syndrome and MRI

Because the vertebral arteries go just superior to the arch of C1 before entering the foramen magnum, the side to side movement of the atlas irritates the vertebral artery by inducing repeated stretching. He goes on to explain that the transient vertebral artery traction and compression may be causing the equivalent of transient ischemia to parts of the brainstem, cerebellum, and cerebral cortex.

And with the stabilization of the C1-C2 motion segment, the repeated stretching of the vertebral arteries is eliminated immediately.


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  • All but one of the patients involved in the study was injured in an auto crash. The one exception was a 49 year old female who had a lifelong history of common migraine headaches, with no history of trauma, who had undergone a C5-C6 fusion surgery previously which provided no relief for her headaches , and originally underwent the cervical DMX study to evaluate the fusion. She was found on the study to have C1-C2 ligamentous instability, averaging 4.

    Book review: The Craniocervical Syndrome and MRI | Life Chiropractic College West

    But four months after the surgery, she had no headaches, and near resolution of her neck pain. Previously, she was having two headaches daily, which she rated as 10 on a pain scale of I wish Dr. Franck practiced here, as I have several patients whom I have not been able to persuade to go to Florida and end their pain. One of the things we know about pain is that the longer it persists, the harder it is to get rid of.


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    In neurology, the law of facilitation tells us that the more often a message travels over a set of synapses, the easier it gets to propagate the signal. This applies not to just motor learning, but also to the transmission of pain messages.

    Craniocervical instability (CCI)

    And we know that chronic pain can actually cause changes- permanent changes- in the central nervous system, so that even after a corrective procedure has been done, the pain might not go away. But the fact that for most of Dr. At this time, there are no neurosurgeons in our area who perform this type of surgery.