Digital Motion X-Ray and Cervical Spine Trauma
I. What is Digital Motion X-Ray?
A. High quality dynamic imaging system—Studies C-Spine in Motion.
B. Objectifies damage to ligaments after trauma/whiplash.
II. Case History
III. What’s the big deal ………..and Who Cares?
A. Forces us to re-think the concepts of whiplash and C-Spine injury.
--Why Attorneys should care: The dilemma of SoftTissue and Low Impact
B. Quantifies post-traumatic injury to ligaments based on established
standards and measurements.
C. Identifies cervical instability in early stages of treatment—Subset
of patients who may be further injured by forceful types of manipulation.
D. Explains why some patients have persistent pain, even after months/years
of therapy: Permanent ligamentous injuries correlate with chronic pain
E. “Alteration of motion segment integrity”—AMA Guides
to the Evaluation of Permanent Impairment: Criteria for Rating Impairment
due to disorders of the cervical spine.
F. Dynamic motion study helps to quantify expectations for future treatment
requirements and predict long-term prognosis.
G. The “S” Word --Why Doctors should care.
IV. Anatomy and Motion Radiology 101 – The Five Minute Crash
A. Bones, Joints, and Ligaments of the Cervical Spine
B. Digital Motion X-Ray – The two minute tour.
V. Which patients should have a Digital Motion X-Ray Study of the Cervical
after a traumatic injury.
A. Significant unexplained pain or headaches after appropriate and/or
B. Suspicion of ligamentous injury.
C. Clinical impression of hypermobility.
D. Other diagnostic studies negative/noncontributory in symptomatic
patient. MRI unremarkable, no fractures, EMG negative, yet patient has
legitimate pain or functional problems.
E. Injured patients in whom direct high-velocity manipulative therapy
F. Schurgin’s law: Above all, do no harm--to the patient ….or
VI. References –See additional handout.