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What Can We See?

DMX can provide valuable information about the stability of all major ligamentous structures in the C-spine (anterior and posterior longitudinal ligament, facet capsule, alar, transverse, and accessory ligaments) in a single evaluation. DMX is exceptionally useful in demonstrating post-traumatic instability in the C-spine that may be responsible for persistent headaches, neck pain, referred pain, and intermittent radicular symptoms. DMX can also identify occult fractures, foreign bodies, and failed fusions that may have been missed in non-motion studies. DMX can assist in determining the course of therapy most beneficial to the patient, especially if manual therapy is being considered. All DMX cervical spine series are interpreted by a board certified radiologist.

Is There Support in the Literature?

Recent medical literature, including several citations in SPINE and Journal of Spinal Disorders, supports the importance of dynamic motion X-ray in the evaluation of the cervical spine. The American Academy of Pain Management Practical Guide to Clinicians, Fifth Edition states: “…digital motion radiography is currently a valuable diagnostic method in evaluating painful hypermobility and instability of capsular and axial ligaments” in the cervical spine. The American Medical Association, Guides to the Evaluation of Permanent Impairment, Fifth Edition cites the radiographic finding of “alteration of motion segment integrity” as criteria for determining “impairment of the whole person.” The Occupational Medicine Practice Guidelines, Volume II, 2004 (American College of Occupational and Environmental Medicine) states: “If probable ligamentous injury with persistent pain [is suspected, then] consider fluoroscopically directed flexion study.” As a board certified specialist in Pain Management, I find DMX to be a powerful diagnostic tool that can identify and quantify the severity of cervical spine ligamentous injury, explain persistent post-traumatic pain, and help direct treatment. For further information regarding supportive medical literature and the application of DMX in clinical settings please feel free to contact us at the above phone number or via E-mail: gappell@cox.net


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