"Clinical Case Presentations of Cranio-cervical Instability" - Myles Koby, MD

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Dr. Myles Koby details the ways in which radiological imaging can help back up clinical symptoms in order to come to a better diagnosis for issues such as cervical medullary syndrome, hypermobility/Ehlers-Danlos syndrome, and more.
Dr. Koby also describes how MRI and neuroradiological imaging can help determine whether a patient will do well after neurosurgery, and can even help describe reasons for surgical failure.
This lecture was presented at the 2019 London Roundtable, provided in partnership with the Ehlers-Danlos Society, discussing issues including dysautonomia, connective tissue disorders, Chiari malformation and related syndromes. (2019)
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[@Rachelspath]

3:25 I am so grateful to hear these points made on imaging CCI patients. My CCI diagnosis was missed for years and it was only after imaging protocols like those mentioned here that my diagnosis was discovered. Thank you DR. Koby.

[@gracerobertson8772]

Thank you for sharing. This isn't important to most people, but for people suffering from these issues your work is invaluable.

[@harryngseymour8326]

9 lop provides

[@sandywhat2429]

Lord what I wouldn’t do to have a specialist like this to read my MRI. I’m suffering and trapped in Canada.

[@janelmcginnis4671]

Thank you for sharing

[@calimongoose8433]

Wow thank you I know what may be causing my symptoms.

[@khalidhudh4466]

Thank you for great presentation. What is the significance of MRA/ MRV in addition to the Plain MRI cervical spine?

[@Raj-ul9my]

Prolotheropy or Prosonotheropy or even PRP is the cure to this problem. Inject the site and this rebuild ligament issue and tightest the over stretched ligaments to the range of motion goes back to how it should be. No screw and rods or fusion to hold your head up or limit your motion. Just prolotheropy or other regeneration treatments would do the cure.

[@umars7425]

I have gotten Prp in my c3 and down and my head definitely feels more sturdy I have yet to get it in my upper cervical to stabilize the ligaments but hoping this will solve the divilitating issues

[@lashawnab.441]

Thank you for sharing bless you . I need a good dr very bad, wish you could be my dr.

[@Tinyteacher1111]

I wish they would respond to comments. It would be so helpful and polite.,

[@sharonkaysummerford7813]

Mailing Cks to read x rays and one mri for ligmaent laxity overlooked and misread last year. mri and 2 x rays this year on dc open mouth.

[@sharonkaysummerford7813]

I see an atlas orthogonol DC so the bones are put back into place but not held by the ligaments.

[@mnr646]

@@sharonkaysummerford7813 same boat... have you looked into the Centeno Schultz clinic for help?

[@Tinyteacher1111]

@@mnr646 I will !

[@SRF-vm3fy]

is there any reported case that is not eds and hypermobile?

[@jellybeansi]

I believe people can also develop craniocervical instability after getting whiplash (or other kinds of neck trauma) or developing poor posture that goes unaddressed for many years (the ligaments stretch and become lax due to gravity/poor positioning). But I'm not a doctor.

[@deloresochoa3593]

The majority of doctors don’t believe in this they think that your mental and need a pill. I’ve suffered from all sorts of symptoms and they tell me that they see nothing wrong. Headaches, ear pain, dizziness, neck pain, low back pain, knee pain, unbalanced, hear palpitations ankle pain. No answers

[@ilikejelly7890]

I have loads of symptoms and the same ones as you, also I have arm and leg pain and tingling. Fatigue and widespread muscle/tendon problems, pain, swelling , memory loss and brain fog etc originally diagnosed with Psoriatic Arthritis, Fibromyalgia, Osteoarthritis. Was at Rheumatologist and I told him I had headache and sore neck and usual pain in arms etc, got MRI , diagnosed with Chiari Malformation and Cervical Stenosis C4,5&6 I was also told I needed a Flexion &Extension scan with movement to confirm Cervical Instability. Seemingly it is the only way it can be diagnosed, I Travelled 4 hours away to get scan without movement and was told no CI. I am now awaiting Chiari decompression surgery and cervical decompression surgery. Don't know what happened with the scan with movement, just didn't get it. Was told for 20 years it was all in my head. Which technically it is but not in the way they thought. Everyone thought I was a hypochondriac. Hope someone believes you and you can get some help soon

[@macintoshimann9892]

@@ilikejelly7890 hey if you’re able I’d highly recommend you give Caring Medical a call. Theyre prolotherapists and treat a lot of people that are recommended for surgery and have a fair amount of success. I just know I would want them to see what they think before being operated on. Im in a boat much like you, have little use of my body, nobody knows anything. In evaluating what can be done with surgery it just seems to make a lot of sense to see some doctors that have success in treating this condition without surgery. That’s my plan anyway. Just my thoughts wish you all the best!

[@ilikejelly7890]

@@macintoshimann9892 I have saw lots of their videos on you tube. Looks impressive. Unfortunately I am in Scotland GB and the National Health Service is on it's knees. If you have the money you can jump the queue so for people like me we have no chance. And they won't offer any other treatment except surgery. Still don't know whether I have CI or not. They never think outside the box that why I have been undiagnosed for 20 years. Wish you every success and maybe you can keep us updated. Good luck.

[@macintoshimann9892]

@@ilikejelly7890 yes I’ll check back at some point. Im in very rough financial shape myself so that dream team is just a hope for me. But I have been able to reconnect with a lot of the muscles in my body with intense rehab and my reversed curve is actually getting better. Will give an update once I straighten out a little more. Its quite interesting because Im actually “getting over” the dystonia? At any rate I wish you some similarly impossible success and hopefully a windfall for us both to get some real treatment 😂

[@ilikejelly7890]

@@macintoshimann9892You sound a lot worse than me my friend and I wish you all the best.

[@Skalekul]

5:32 "There was no signal change on the t2 weighted images... which is a very late sign" Can you explain why the absence of any signal changes signifies this being a late sign?

[@alexandermills382]

I think he meant the patient had not progressed to late stage so her T2 weighted signal was normal.

[@Nidge.]

I pray for your help with my pain my only hopes i win the lottery and pay to go get the op shoulder pain neck pain can't put pillow under my head for 2 yrs now it irritates nd cause discomfort can i do exercise to fix my issue im just 10 days over my skin cancer on my ear nd had limp node removed from neck please help

[@ronaldinho10747]

Why don't they use prolotherapy to strengthen the tendons which is the root cause of instability? Always surgery...

[@Soft7y]

Prolotherapy isn't very well researched yet

[@larryrobinson1399]

@@Soft7y .. one doc in Florida doing it caring medical of Florida but I’m a bit on the edge

[@Soft7y]

@@larryrobinson1399 till there's more research or proof, I would hold off personally

[@larryrobinson1399]

@@Soft7y his reviews are to good , what other route to you recommend for c1 misalignment ? Some say different exercises others say chiro

[@Soft7y]

@@larryrobinson1399 Definitely not chiro. try prolotherapy but dont get your hopes up. excercises and physical therapy are the way to go unless its really bad then talk to surgeon about fusion

[@wigglywrigglydoo]

Wouldn't an upright MRI be a better choice?