He's on the FREE veterans plan now... been a patient of mine for years, has a great Curve, but nasty headaches. Always felt I was missing something with this guy, then I refilmed his neck and looked at it more from an Upper Cervical perspective.



I love this stuff! Using the Tytron pre and post and looking closer at the films charges me up! Any suggestions from the experts out there on how to handle this stuff is appreciated.

Rob,

If the ADI is shaped like a "V" with the opening superior, wouldn't the Atlas be superior? (the neural arch is "up" or "closer" to the occiput, creating the opening to the "V."

According to BJ in volume 18, first thing above all, there has to be ATLAS laterality for there to be atlas subluxation. The shift or "wedge slip" of atlas determines laterality and can be measured when you compare level plane of atlas (by drawing connecting lines between tps, inferior edges of lateral masses, tp/lateral mass juction, whichever is more visible) and a lateral line connecting the jugular processes on the skull. Both atlas plane and skull plane lines should be PARALLEL. If they are not, the side to which the lines converge is considered the side of laterality for atlas.

If there is no laterality, there can be no atlas subluxation, even if the lateral AD space appears v like. The v is from the POSTERIOR tipping of Axis's dens back into the anterior aspect of the spinal chord.

Superiority and inferiority of atlas is determined from the ANTERIOR arch of atlas. So if the AD space appears like a V, then that is atlas INFERIORITY (atlas tipping downward). If the AD space appears like an upside down v, then that is atlas SUPERIORITY, atlas appears inclining upward. Note S or I is NOT determined by the posterior arch as you posted.

The skull and atlas plane lines ran parallel in this situation, so no laterality of atlas, assumed C2 subluxation instead. Check me against volume 18 on this to be sure.

Rob,

Nice post...I was going on gut and am glad it prompted you to make this post. time to read Vol 18.

AIL

I believe the listing is determined by comparing a level in relation to the one below. When analyzing the upper cervical area, there are three important lines: the transverse condylar line for the occiput, the transverse atlas line and the axis plane line.

Occiput listing is determined by comparing the condylar line to the atlas line. Laterality is considered on the side of DIVERGENCE by some (primarily radiologists) assumed due to swelling of the disc and capsule from the subluxation. Others (like Toggle Recoil technique) consider the laterality on the side of CONVERGENCE due to the way the atlas and occiput move in relationship to each other.
Atlas listing is determined by comparing the transverse atlas and axis plane lines.
Axis listing is determined by comparing to the C3 plane line.

If the condylar and axis lines are parallel to each other and the transverse atlas line is not, that usually indicates atlas subluxation. If the tranverse atlas and axis plane lines are parallel and the occiput condylar line is not, that usually indicates occiput subluxation.