CCSVI and CCVBP

[uprightdoc]

Hmm. I know you told me you have a twin brother who doesn't have MS. I know you are using LDN for spasms, mostly in the legs. Did you ever give me your complete history?

[uprightdoc]

Hello Blossom,

I went through your cervical scans again yesterday. As we have discussed before, you have significant degeneration (spondylosis) causing bulging of the discs into the spinal canal and considerable compression of the thecal sac (epidural space) of the cervical spine from C3 all the way down through C7. The thecal sac (epidural space) is between the inside wall of the spinal canal and the cord. The epidural space contains the vertebral veins. In other words, your vertebral veins are squashed. This casuses venous hypertension, which is suspected of causing ischemia (decreased arterial blood flow) of the cord. In my opinion it also causes chronic backpressure against the drainage system of the brain as well and it increases pressure acting on the cord. In this regard, the front side of the cord contains the motor tracts for muscles.

As we also discussed the degeneration has resulted in excess curvatures in the upper back (thoracic spine) and the cervical spine. This is pulling the thoracic portion of the spinal cord tight toward the back side of the spinal canal. I suspect this is why you feel better when you tip your head backwards. The back side of the cord contains sensory tracts.

In brief, your cord is getting squeezed from both the front and back side. Surgeons shave down or remove bulging discs to relieve stenosis and decompress the spinal canal on the front side. Neurosurgeons remove the posterior arch of the upper cervical vertebra to relieve pressure on the back side of the brainstem and cord. Removing the posterior arch weakens the spine and consequently requires plates and screws for stabilization. The procedure has been in use for a long while and has a good success rate for Chiari malformations.

There are many people in the same situation as you and surgical solutions are close for sure. To start with, surgeons have to recognize the cause of the problem, which is spondylosis and stenosis. In this regard, phase contrast cine upright MRI of the brain and cervical spine will allow them to properly assess the situation and locate the area causing the most problems. This will allow them to layout an approach that makes the most sense for relieving pressure and improving flow.

[civickiller]

if you could please take a look at these, brain, c spine, thoracic spine, and lumbar spine scans. that all i got.

http://s305.photobucket.com/albums/nn23 ... 0MRI%2011/

pretty good memory Dr. F. going to look if i gave you a history, i cant remember

[blossom]

dr. flanagan, when i read all this and i know we went over it before and i appreciate your patience and help.

i am overwhelmed in which way to pursue this. first through the yrs. any neurosurgeons pretty much fluffed me off. the way they look at it is all this would not cause my symptoms. i've told this story too much.

i have been getting in touch with spinal lazer dr.s and getting things together to send them. i though this is the safest and least invasive. are they? only 1 will work with medicare the others are self pay. either way after all this i want to go the best of the best way. this i feel is my last hope. i really don't have any severe pain in my spine right now and i can't chance a screw up in any way. and don't want to be worse off that way.

when you say neurosurgeons do this and surgeons {do you me orthopedic surgeons?} do the other i am at a loss. you would think when they look at my spine they would be ready to try and help. maybe if i just lie and say i have severe pain. it seems that's what they want to hear. i have pain but it doesn't qualify severe or maybe i just handle it. everything else is much worse.

i'm pretty much on my own with this and right now i kinda feel like chicken little and the sky is falling. "which way do i go which way do i go"!! plus i'm running out of time and strength. and i dread trying to find the right dr. or dr.'s to do this. and i don't want nor can i afford physically, mentally or financially to screw up.

do you know of anywhere or any dr. or dr.'s that perhaps are working with this whole theme of things say like the studies the chiro.'s are doing and would be qualified to do what i need?

of course close to home would be nice but i'll travel to get the best and best results possible.

to sum it up-if you were me-where would you go and what dr. would you choose? i am just overwhelmed right now and afraid i'll go about it wrong. you haven't steered anyone wrong and i trust you and your knowledge.

[civickiller]

this is the only history i gave you, let me know if you like to know more

Brief history of head truma, age 13 fell 10 ft on my back hitting my head. Doing head hand stands June '05, fell and the next day I had my first MS exacterbation(sp?)

and actually now i thought about it more, ive had tinnitus(sp?) long before my age 13 trauma, as early as i can remember. ive always thought everyones complete silence involved that ringing sound because thats all i ever heard. when i was 2, i was running around and i fell face first into this little 1.5 ft high cement statue with a pointed top. i have to ask my mom if she saw me fall. i got the scar on my forehand to prove it, how could i forget i have it written on my forehead

[uprightdoc]

Hello Blossom,

Neurosurgeons typically work on the cervical spine. The problem with cases like yours is that you have multiple discs that are involved. The difficulty lies in convincing neurosurgeons that the discs are causing the problem. They then would have to decide which segments to work on for the most benefit.

Fortunately the technology is here now for doing the surgery. The latest endoscopic laser surgery is minimally invasive and recovery times much faster. Rather than removing the bad disc like they used to do, such as in herniated discs in the low back, or meniscus problems in the knees, now they simply shave down the bad part that buldges out. In your case the discs buldge into the canal causing stenosis.

As for convincing surgeons that the degenerated discs are causing the problem, phase contrast cine upright cervical MRIs will allow surgeons to see and determine the impact of spondylosis, stenosis and curvature problems on blood and CSF flow. If surgery is a consideration, it will also help them to determine the best approach to removing the obstructions. Motion x-rays and cervical MRIs are also a consideration.

The other important point to consider is that there is no way to determine before surgery how much permanent damage has been done at this time. This means the surgery could be successful but it may not improve the signs and symptoms.

While I don't have anyone in particular to refer you to, you have plenty of time to shop around. You need to look for senior surgeons with plenty of experience with cases of cervical spondylosis like yours. There is no doubt about it. Trauma causes spondylosis, stenosis and scoliosis, which play a significant role in neurodegenerative conditions such as MS.

[uprightdoc]

Thanks Civic,
You never told me your history before. Now your case makes much more sense to me.

[NZer1]

http://uprightdoctor.wordpress.com/2011 ... and-cysts/

Bit of reading for us.

Dr the vein and CSF resistance to flow has gained the attention of many from both fields, vascular and others, good to see at last. How this effects the health of us all is going to be another learning curve!
There is a big risk with assumptions at this early stage in the game, so many ideas, theories and a lack of understanding that already exists, will send this in all directions. The interplay with systems such as the nerve transitions which are poorly understood will rattle the medical community and open some cracks in the knowledge (mine) field.

Regards Nigel

[uprightdoc]

Blossom,

Your C5/6 disc is the worst. The C5/6 disc is next to the last one in the lower neck, where the cervical cord gets wider. The bad disc is almost touching the cord if it isn't already. The C4/5 disc above it isn't much better. They are significantly obstructing venous blood flow through the vertebral veins and causing venous hypertenion. The venous hypertension is most likely affecting blood and CSF flow in the area and increasing pressure acting on the cord. If you decide to go the surgical route, you need to consider endoscopic surgery on both equally bad discs.

[blossom]

dr. fanagan i do not feel i have plenty of time left to shop around as i am going down hill faster. if i get that i can no longer transfer it will be a different ball game.i pray my next ultra sound still shows flow.

i can not do anything hasty and won't -the lazer surgery is what i've been tryng to get my info. to. i have found none with an upright mri at their facility. i've had other things on my plate to deal with. but,will pursue. this is not going to be easy to find what i need and who i need.

in the meantime i am trying to keep my head on straight.
i can not think right now the name of the type of chiro. but they work very slowly and long on the skull or anythng else that may help me until i can hopefully find the right dr. to do what i need and do it right.

please keep your eyes and ears open and let me know.

[NZer1]

Hi all, Dr. I have been experiencing some strange symptom changes since the first attempt to correct my atlas alignment and it is only this evening that I have been able to language what is happening. In my opinion my MS progress has been a little quicker since Nov last year when the first attempts at correcting my Atlas.
The change feels like my spinal cord is shrinking and being stretched and causing me to go into more of a fetal position, the more that Graham has used Network Spinal Analysis treatments the more I have felt that my spinal cord is too short for the length of the bony spinal column.
With the Upright MRI findings (restrictions in CSF flow in MS) I am beginning to wonder about atrophy of the cord, if the brain atrophies in MS, then why not the cord?
The injuries to the cervical spine and the disrupted CSF flow and the lesions on the cord in MS disrupting CSF flow, bulging discs and spurs all disrupt the CSF flow. Is it possible that there is atrophy of the cord due to lack of CSF flow, which is shortening/shrinking the cord and causing symptoms.
For me I feel better if I have my head forward rather than in a 'normal' upright position, I have bulging discs, de-generating discs etc and the contact of the cord inside the column seems in my mind to be the issue, tethered cord?

*Is upright MRI the only way to understand what is happening in this type of situation?

Regards Nigel

[uprightdoc]

i do not feel i have plenty of time left to shop around as i am going down hill faster.

the lazer surgery is what i've been tryng to get my info. to. i have found none with an upright mri at their facility.

in the meantime i am trying to keep my head on straight.
i can not think right now the name of the type of chiro. but they work very slowly and long on the skull or anythng else that may help me until i can hopefully find the right dr. to do what i need and do it right.

please keep your eyes and ears open and let me know.

Hi Blossom,

What I meant is that there is nothing imminent about your condition. The discs are not getting worse and your cord has been dealing with the pressure for years. Several months more isn't going to matter at this point.

You can use NUCCA or and Applied Kinesiology or Sacrooccipital Technique chiropractor to help keep your head on straight while you carefully consider, search for, and consult with a good surgeon.

It isn't laser surgery so much that you should be considering. What you want to look for is endoscopic cervical disc surgery. Laser is just one way of surgically removing the bad bulging parts of the disc. Other surgeons use different devices such as suction or scalpels. The key difference is the endoscopic approach which uses a small incision to stick in a tube for the surgeon to work through. It's now being used on the brain, which opens doors for many possibilities. Like all the latest surgeries it is much less invasive than older methods and easier on surrounding tissues so patients recover quickly with far fewer complications. The trick with endoscopic surgery is that the surgeon has to work through small tubes. I don't think you have to travel that far to find a good surgeon. They have some good hospitals and surgeons in your neck of the woods as well as New York.

[uprightdoc]

Hi Nigel,

Upright MRIs would certainly be helpful in cases like yours and many others for that matter. Conventional scans will show atrophy of the brain or cord which I doubt you have. On the other hand, tethering of the cord and Chiari type malformations are a good possibility in your case due the presence of Lehermitte's and cranial nerve signs. Is Graham doing upper cervical or mostly NSA.

[uprightdoc]

Hello all,

Dr. Raymond Damadian just ordered a copy of my book. I am honored. He is the fourth radiologist to read it after Drs. Noam Alperin, Mark Haake and David Harshfield Jr. For those of you who don't know, Dr. Damadian invented the MRI and is the president of Fonar corporation, which manufactures upright MRIs. He just recently published a study showing a connection between MS and trauma.

Blossom,

For now, you should forget about upright cervical MRI and focus on finding a good surgeon first. There is enough evidence on your current cervical MRI for the surgeon to consider. Upright and phase contrast cine upright MRI should only be necessary if the surgeon wants more convincing evidence that the bad discs are impacting the cord.

[NZer1]

Hi Dr. I have had two adjustments on my Atlas using a drop table, all of the other visits have been NSA. In my opinion it is a case of the blind leading the blind.
At some level our bodies must be doing the best they can to accommodate the effects of injury and wear and tear, and there must also be a point where the body cannot correct any better than it has. To try getting a structure to 're-align' to a anatomically correct position is going to be a trial and error situation. It may not be achievable.
I believe that Graham has done well with realigning my Atlas, which is really only going to be proveable by xray?
I personally think that muscle testing is a little risky to only go by and in the same breath that xray will not tell all the story.
At this point in time I am going to research having Upright MRI, it looks like I will need to travel to Australia. I am hoping that my GP's latest request for a Neuro assessment will be successful, if not the local MP is our MS Society Patron and has offered help to 'motivate' the Neuro to see me and my objective is for an MRI to see what if any changes since my last MRI about 2 years ago. That will also give me a comparison if I get an Upright MRI done.
The reality is that my 'MS' symptoms have progressed during the whole time (11+ months) since having the first adjustments and there are too many other possibilities for cause for me to only focus on alignment.
I have a close friend who has just traveled to Dr. Sclafani to have PTA after having two PTA's done in NZ that were under inflations, so the jury is still out on what in my mind is the best next step. My sister and her Husband are going to the States next April and have offered to be support for me if I want to go to Sal for PTA treatment. So my mind is over running a little at the moment especially with symptoms progressing and my mobility is at the stage of hindering my ability to walk, a major concern as I have always been so active, and my self image is about being the active, out doors type person. My vision and mental fog is of as much concern although it is easier to pass off as it must be age!
Food for thought.
Regards all,
Nigel