Team „Cervical spine instability“


For a condition like cervical spine instability, especially cranio-cervical instability a team approach is needed, most important regarding the diagnostics.

Although by using radiological methods the diagnosis of CCI can already be made, there are several disciplines that can help discover the full extent of the disease.

Here is a brief overview of the possible disciplines which can be incorporated in the CCI diagnostics and their potential benefits.

GP: For me, this is a central point of my health care. My GP keeps track of all the results and overlooks the big picture, supports applications for health insurance matters, disability, etc., prescribes medications and physical therapy and helps generally in dealing with my conditions.

Neurosurgery: Similar to GP but more specific for therapeutic approaches and potential surgery. Gives recommendations for additional diagnostics.

Radiology / Neuroradiology: Evaluates MRI, CT and X-ray images. Comparing old and new images and supports the neurosurgeon with decision making. Provides recommendations for additional testing.

Neurologist: Neurology is a very important area but unfortunately often they do not really want to deal with CCI. Nevertheless, neurology offers some tests that could be pointing the way. Possible tests that could show spinal cord damage, autonomous nerve system disorders or brain stem damage are nerve conduction studies, sensory-evoked potentials, EEG, neuropsychiatric tests.

A small part of neurology is the area of autonomous nerve system testing that could show any dysregulation.

Another small area of neurology is otoneurology which shows disturbances between the brain stem, eye movement and hearing.

Patients that suffer from bowel or bladder dysfunction can visit neurourologists or neurogastroenterologists.

Orthopedics: The orthopedics is similar to neurosurgeons but more focussed on non-invasive strategies to treat your instability. He can help you to decide whether surgery can help or not, can treat you after surgery and support you with any requests concerning insurance or disability.

Physical therapist: They cannot only suspect CCI by using specific manual testing methods but also draw conclusions which nerve is damaged by testing different muscle groups. Furthermore they of course take care of our non-invasive treatments before and after surgery and in the best case they prevent you from needing surgery. PT’s are probably the most important team member.

Paraplegiology: As the name suggests the paraplegiology deals mainly with patients that suffer from spinal cord damage but they might be useful for cervical spine instability too.

Internal medicine / environmental medicine / holistic medicine: There are some supportive nutritional treatment concepts that might improve some symptoms of CCI.