Ross Hauser, MD

Many patients with cervical spine instability have been chasing a diagnosis for years. At some point these people, probably you or your loved one, start to realize that their chase is nowhere near the endpoint because they continue to have worsening symptoms and continue to receive ineffective treatment with the addition of possibly unneeded medications that do not help. In our office, one of our diagnostic tools is a Digital Motion X-ray. We use tools because they can help reveal a missing diagnosis.

Video discussion

In this first video a patient shares his experience with dizziness and light sensitivity coming from neck instability, and treatment with Prolotherapy here at the Hauser Neck Center. His story is similar to many people who we speak to and see here for care. **DISCLAIMER: As with any medical treatment, no guarantees or claims of cures are made as to the extent of the response to treatment that every person experiences. Every therapy/treatment has patients who experience varying levels of success and failure. Results may not be the same from patient to patient, even with a similar diagnosis, as the body’s internal status is unique to each individual.

The search for the missing diagnosis

For many people, a digital motion x-ray can reveal a series of missing diagnoses and possibly end your chase for that elusive diagnosis that finally responds well to treatment. A digital motion x-ray is exactly what it sounds like. It is a moving picture x-ray.

Head, neck, jaw, and face pain

In our 30+ years helping people with chronic pain of the head, neck, jaw, and face we have seen many people with a diagnosis of Trigeminal neuralgia. For some of these people, possibly including yourself, it was not easy getting this diagnosis as this problem can be confusing and frustrating to understand. Not only for the patient but the doctor alike. The problems of diagnosis to determine where your source of facial, head, and jaw pain is coming from is covered in our article: The evidence for Trigeminal Neuralgia non-surgical treatments.

Painful, involuntary muscle spasms in the neck 

• Lateral head tilting is linked to Torticollis, painful, involuntary muscle spasms in the neck with a resulting head rotation and tilting to one side. In the 2020 medical publication STAT Pearls, the authors noted, “There may be several presenting positions, including flexion, extension, right or left tilt (in Torticollis.) (2) See our article Cervical dystonia and spasmodic torticollis treatment.

Dizziness, loss of balance, sometimes nausea, sometimes vomiting

• Lateral head tilting is linked to Benign paroxysmal positional vertigo or BPPV. Some of you reading this article may have been offered this diagnosis with a somewhat reassuring tone that your dizziness, loss of balance, sometimes nausea, sometimes vomiting is something that can be managed, may go away on itself, and this will be more of a nuisance than anything. That is why it is called “Benign.” For some people indeed, this does happen, for many patients we see, the dizziness did not go away and it continues on. Please see our article Cervical Vertigo and Cervicogenic Dizziness.

The problem of the posterior ponticulus revealed

At 1:45 of the video:

The next thing that we see, that may not be discovered by conventional x-ray is that the patient, this mother of three, has a unilateral posterior ponticulus and what that is it’s a fancy word for a little bone formation at the C1 that sits by her vertebral artery. The vertebral artery is one of the major supplies of blood between the brain and the spine. So when you have posterior ponticulus,  any injury to that upper cervical spine is going to leave the patient more prone to headaches, dizziness, lightheadedness, or simply a feeling of being a little bit off-balance, and neck pain. This problem can also be causing our patient’s vertebral blood supply loss.

In this image from the video and article Understanding Ponticulus Posticus, Ross Hauser, MD explains that in advancing cervical spine instability and neck problems, and with seemingly no alternative, the posterior atlantooccipital ligament transforms itself into a bony structure to “bridge” over the foramen in a last attempt to prevent vertebral artery and sub-occipital nerve compression. The last chance to fight off cervical instability.

C1-C2 – the anterior-posterior open mouth view reveals cervical dysfunction in motion and more clues to the cause of the patient’s symptoms.

If you went to the hospital or your doctor and they suspected a problem in your upper cervical spine, they may recommend an anterior-posterior open mouth (APOM)  x-ray view. This again would be a “snapshot,” or an image of a single moment. The difference with digital motion x-ray is that we are able to watch your neck move in real-time and see how in real-time motion how your C1-C2 interact and work, or not work together.

Caring Medical Patient Stories of overcoming dizziness: