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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does This X-ray Report Post Concussion Indicate?

This is my son s x ray..what would you suggest? Patient presents with 4 weeks of HA s. Concussion playing football 2 years ago. MVA 1.5 years ago. Wrestles and the season ended 4-5 weeks ago. Performed lateral flex/ext and APOM Latflex DMX. There is a slight spondylo with flexion of C2 on C3, C3 on C4, and C4 on C5. (The posterior edges of the vertebral bodies should line up and when he moves you can see how they line up with extension but slide with flexion.) There is damage to his Alar and Accessory ligaments due to the sliding of the atlas on C2. (This is seen on the APOM and when he tilts you can see the outside bottom edge of C1 move and not stay adjacent to the top edge of C2. This happens on both sides and I measured it to be around 4mm bilaterally. Then note the space between the Odontoid and the inside if the Atlas. This distance moves with lateral flexion. It should be equal at all times.)
posted on Fri, 15 May 2015
Twitter Tue, 21 Feb 2023 Answered on
Twitter Thu, 23 Feb 2023 Last reviewed on
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General & Family Physician,  's  Response
Hi,

Based on the X-ray report, your son has some abnormalities in his cervical spine (neck), particularly at the C2-C5 vertebral levels. There is a slight spondylosis (spinal misalignment) with flexion of C2 on C3, C3 on C4, and C4 on C5, which means that the posterior edges of these vertebral bodies do not line up properly and move when your son flexes his neck.

Moreover, there is damage to your son's Alar and Accessory ligaments due to the sliding of the atlas on C2. This is seen on the APOM (anteroposterior open-mouth) view, where the outside bottom edge of C1 moves and does not stay adjacent to the top edge of C2. The distance between the odontoid (a projection on the C2 vertebra) and the inside of the atlas (C1 vertebra) also moves with lateral flexion, which should be equal at all times.

These findings suggest that your son may have suffered a neck injury that has affected the alignment and stability of his cervical spine. Given his history of concussion, MVA, and wrestling, it is possible that these events have contributed to his current symptoms of headaches. It would be best to discuss these findings with a medical professional, such as a neurologist or orthopedic surgeon, to determine the appropriate course of action. They may recommend further imaging or refer your son to physical therapy to address any issues with his cervical spine.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Priyanka, General & Family Physician
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What Does This X-ray Report Post Concussion Indicate?

Hi, Based on the X-ray report, your son has some abnormalities in his cervical spine (neck), particularly at the C2-C5 vertebral levels. There is a slight spondylosis (spinal misalignment) with flexion of C2 on C3, C3 on C4, and C4 on C5, which means that the posterior edges of these vertebral bodies do not line up properly and move when your son flexes his neck. Moreover, there is damage to your son s Alar and Accessory ligaments due to the sliding of the atlas on C2. This is seen on the APOM (anteroposterior open-mouth) view, where the outside bottom edge of C1 moves and does not stay adjacent to the top edge of C2. The distance between the odontoid (a projection on the C2 vertebra) and the inside of the atlas (C1 vertebra) also moves with lateral flexion, which should be equal at all times. These findings suggest that your son may have suffered a neck injury that has affected the alignment and stability of his cervical spine. Given his history of concussion, MVA, and wrestling, it is possible that these events have contributed to his current symptoms of headaches. It would be best to discuss these findings with a medical professional, such as a neurologist or orthopedic surgeon, to determine the appropriate course of action. They may recommend further imaging or refer your son to physical therapy to address any issues with his cervical spine. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Priyanka, General & Family Physician