What is cranio-cervical instability (CCI) ?
It is a condition when the skull does not sit on the neck in a stable and safe position. It is caused by lax or injured ligaments which are responsible for stabilisation of the neck and skull. When these ligaments get loose, any head or neck movement is unstable. The lack of stability affects further other structures in the neck, such as joints, joints capsules, muscles and so on.
What causes CCI ?
One of the most common causes is neck injury, such as whiplash, which is incredibly common type of injury. It happens when a sudden force is applied to the neck. The most common example is whiplash injury when a car is hit from behind. The other cause of loose ligaments is EDS.
What are the symptoms of CCI ?
Patients usually present with plethora of symptoms, such as headaches, neck pain but also blurred vision, brain fog, heart palpitations and so on. The clinical diagnosis is difficult and the problem is often missed, and patients are sent from one specialist to another without proper diagnosis and treatment.
How is CCI diagnosed ?
The best way to diagnose CCI is imaging. But a standard, static x-rays or scans won’t show neck instability. CCI diagnosis requires more sophisticated and specialised imaging, such as movement-based x-ray (DMX) and upright dynamic MRI. The interpretation of the imaging requires skills and experience.
What are the treatment options ?
The treatment includes specific exercises, chiropractic manipulations, which, like imaging, require high skills and experience. If these treatments fail, next step is injection therapy, focused on the C0/1, C1/2 joints and joints capsules injection, further facet joints injection, posterior ligament and muscles injection. If these injections do not help, the next step is PICL procedure which involves injection directly into the anterior (alar and transverse) ligaments. Finally, the surgical fusion is also a possibility.
What we do for CCI ?
In Algocells-Regenexx clinic (www.algocells.com) we provide treatments which involve Platelet Rich Plasma (or stem cells) injection into C0/1, C1/2 joints and capsules, into further cervical facet joints, posterior ligaments and muscles. We also collaborate with Dr Iain Smith, a Chiropractor, who specialises in CCI and has a vast experience in treating this condition providing upper cervical specific chiropractic manipulations. This type of intervention is image guided and low force. We can also arrange an MRI imaging in London, dedicated to CCI diagnosis. The scans are assessed and interpreted by one of the leading Neuroradiologist, specialising in CCI.
In 2015 a nonsurgical treatment option for Cranial Cervical Instability was developed at the Centeno-Schultz Clinic. The procedure called Percutaneous Implantation of Cervical Ligaments (PICL), involves the injection of a patient’s own bone marrow concentrate which contains stem cells into the damaged Alar and Transverse ligaments.
We don’t do PICL procedure, which in Regenexx is done exclusively by Dr Chris Centeno in Colorado. PICL procedure is not risk free, therefore Dr Centeno accepts for treatment only those patients who failed more conventional methods, including C0/1 and C1/2 injection.
So if you think or you know that you suffer from CCI, please, contact us and we might be able to help. If our treatments did not work, we will be happy to refer you to Dr Centeno, should you wish us to do so.
