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"…unlike other vertebrae, which interlock one to the next, the Atlas (also known as C-1) relies solely upon
tissue (muscles and ligaments) to maintain alignment; therefore is uniquely vulnerable to displacement.
Displaced C-1 can occur without pain and thus, often goes undetected and untreated."

–George Bakris, M.D.,
Director of the Hypertension Center at the University of Chicago Center

Upper Cervical Research Articles

Upper Cervical Chiropractic Management of a Multiple Sclerosis Patient: A Case Report [May 2001, Vol 4, No.2 JVSR]
Erin L. Elster, D.C.

Abstract

Abstract - This article reviews the upper cervical chiropractic care of a single patient with Multiple Sclerosis (MS). This 47-year-old female first experienced symptoms of Multiple Sclerosis (MS) at age 44, when she noticed cognitive problems and loss of bladder control. After viewing multiple lesions on MRI (MS plaques), her neurologist diagnosed her with MS. Two years later, she noticed additional symptoms of leg weakness and paresthesias in her arms and legs. Her symptoms progressively worsened without remission, so her neurologist categorized her as having chronic progressive MS and recommended drug therapy (Avonex).
Upon initial examination of this patient, evidence of an upper cervical subluxation was found using precise upper cervical radiographs and paraspinal digital infrared imaging. The patient’s medical history included one possible mechanism (a fall approximately ten years prior), which could have caused her upper cervical subluxation. The patient was placed on a specially designed knee-chest table for adjustment, which was delivered by hand to the first cervical vertebra according to radiographic findings.

Monitoring of the patient’s progress was through doctor’s observation, patient’s subjective description of symptoms, thermographic scans, neurologist’s evaluation and MRI. The patient was managed with upper cervical chiropractic care for two years.

After four months of upper cervical chiropractic care, all Multiple Sclerosis ( MS) symptoms were absent. A follow-up MRI showed no new lesions as well as a reduction in intensity of the original lesions. After a year passed in which the patient remained asymptomatic, another follow-up MRI was performed. Once again, the MRI showed no new lesions and a continued reduction in intensity of the original lesions. Two years after upper cervical chiropractic care began, all MS symptoms remained absent.

This case report revealed that this specific upper cervical procedure (thermal imaging, cervical radiographs, and knee-chest adjustments) was associated with a successful outcome for a patient with Multiple Sclerosis. Post MRI’s, post thermographic scans, and the patient’s neurologist’s evaluation all suggested the intervention of upper cervical chiropractic care may have stimulated a reversal in the progression of Multiple Sclerosis.

Changes in General Health Status during Upper Cervical Chiropractic Care

Proceedings World Federation of Chiropractic, 5th Biennial Congress, Aukland, NZ, May 17-22, 1999.

Kathryn Hoiriis, DC
Deana Burd, BS
Edward Owens, MS, DC

Abstract

Introduction:

Outcomes research can be used to test the efficacy and effectiveness of chiropractic care. In this study, the Global Well Being Scale (GWBS) and the Rand SF-36 (SF-36) were used as outcome measures in a practice-based research project. Upper cervical specific practitioners obtained data from their patients without regard to type of complaints. The data was collected and analyzed by researchers at Life University and Sherman College.

Methods:

Field doctors were recruited to contribute information from their patients. Patients were recruited sequentially from the new patient population and were followed through the course of care until maximum improvement was noted. Patients recruited were between 18-59 years of age. The SF-36 was given at the initial patient visit, at four weeks of care and at maximal chiropractic improvement (MCI). The GWBS was administered at each visit and recorded along with the adjusted spinal segments on the patient's visit record. Subluxation specific x-ray misalignment factors were collected for comparison to other outcome measures.

Results:

The results of the analysis on November 15, 1998 from 260 patients seeing twelve field doctors are compared to more recent analysis for 311 patients. The male/female ratio and the average age of the population did not change. Female patients (60%) outnumbered male patients (40%) in this population. Average age was 38 years, with distribution as shown below.

Entering Complaints:

Care was sought for a variety of mostly musculoskeletal complaints. As shown below, back pain (33.9%), neck pain (40.9%) and headache (9.8%) were the most common.

X-ray Listings:

The average pre-adjustment C1 misalignment was 2.2 degrees.

Atlas laterality was to the right in 57% and to the left in 44% of the patients (below left). Atlas rotation was anterior 57%, neutral 4%, and posterior 39% of the time. The lower angle was to the right 39%, neutral 3%, and to the left 58%. The average measured radiographic change was 51-75% with the average post-adjustment C1 misalignment reduced to 0.89 degrees.

Initial SF-36 scores of the chiropractic patients are well below the general population norms. Improvement is noted in all subscales at 4 weeks, on the average. Further improvement in SF-36 scores is shown at MCI, where values in 5 of 8 subscales exceed the normative values.

Global Well Being Scale:

The GWBS is a 10 centimeter visual analog scale that patients use to report their current perceived state of well-being, with 10 being optimum. GWBS data is recorded at each visit to the chiropractor. A plot of average GWBS scores as a function of time (visit number) shows a rapid initial increase in the first 8 visits, and gradual, continuing benefit past 20 visits.

Conclusion:

Statistically significant improvement was seen for all SF-36 subscales at 4 weeks and MCI. Patients in this sample presented mainly with musculoskeletal complaints. Analysis of X-ray listings suggested that upper cervical chiropractic adjustment successfully reduced misalignment of the occipito-atlanto-axial (C0/C1/C2) complex. An improvement in global well-being was also demonstrated by the GWBS scores.

This has been a cooperative study, carried out and funded by Life University and Sherman College.