CCI, AAI and spinal instability​

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A Chiropractor, physiotherapist, radiologist or similar can diagnose me with CCI and AAI.

- FACT: While a chiropractor, physiotherapist, radiologist or similar practitioner may recognise signs suggestive of CCI/AAI or refer for further investigation, the definitive diagnosis of CCI/AAI — given the need for dynamic imaging, specialist interpretation and management planning — is generally made by a physician (such as a neurosurgeon or neurologist) with expertise in the upper cervical spine.

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Everyone with CCI and AAI will need fusion eventually

- FACT: Many can manage with less invasive treatments, like physical therapy and a cervical collar. A surgical fusion is a last resort in severe cases

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A fusion will cure CCI and AAI.

- FACT: There is no cure for CCI+AAI, and while fusion can be both life saving, and significantly improves quality of life, some symptoms are likely to persist. There's currently no way to properly assess the extent of damage to the brainstem and spinal cord, which makes it hard to predict the outcome of fusion surgery, from a symptom improvement perspective. 

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My MRI/X-ray was read as clear, so i can't have CCI/AAI

- FACT: Most medical professionals are not knowledgeable on ligament laxity related instabilities, such as CCI and in some cases AAI. This means they won't order the right imaging or make the right measurements to assess it. Always see a CCI knowledgeable practitioner if you suspect you have it 

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Any neurosurgeon can diagnose CCI/AAI 

- FACT: Unfortunately CCI/AAI from ligament laxity is still rarely known amongst doctors, even neurosurgeons. The misconceptions about these conditions are widespread, many have not even heard about them.

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Severity of measurements equal severity of CCI/AAI

- FACT: The severity of ones instability is based on a mix of measurements, neurological findings and symptoms. Someone might have severe measurements, but only mild symptoms and no neurological findings and vice versa

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Intracranial hypertension​

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Everyone with IH has papilledema

- FACT: While it is not common, it is possible to have IH without papilledema. It's estimated that between 5-10% of IH patients do not have papilledema.

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IH headaches get worse when you're lying down, and better when you're upright.

- FACT: While a positional headache that comes on when upright is the most common experience, what position triggers pain can vary from person to person.

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IH is always idiopathic/without a known cause

- FACT: There's two types, one being idiopathic, the other being secondary. Recent studies have shown a link between cerebral venous stenosis and intracranial hypertension

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Tethered cord

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Tethered cord can always be seen on MRIs

- FACT: Tethered cord might be occult, and therefore not be visible on MRIs

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Tethered cord is something you're born with

- FACT: Tethered cord can be caused by an injury or trauma, such as previous surgery to the spine causing scar tissue to form

 

 

Chiari malformation

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Only a large herniation causes symptoms

- FACT: All sizes of herniations can cause symptoms, as it comes down to compression of the surrounding structures as well as blockage of CSF flow.

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