Question
QUESTION: hey, i'm 16 years old and i was in a sledding accident about 7 weeks ago..  i do not remember what exactly happen but all i remember was sledding down a hill and i woke up in a hospital.  they took 2 different cat scans with showed miss-alignment at C1 and C2 area.  they took the 2nd cat scan and it came back normal..  but later that week i went back to get an MRI done with found out i have 2 bulging disk at C5 and C6..  the bulging disk isn't a problem but there is a weird popping sound coming from the top of my neck in the C1 and C2 area..  I tilt my head kind of downward and turn and it pops.. its just a little turn..  I turn it to the left, it pops, then to the right, then pops..  it never misses a pop..  when it pops then i get dizzy..  the dizziness might be because it vibrates my neck or something.. i really don't know..  i thought maybe you might have some idea of what is making this popping sound?  no one knows what is going on..  all i know is that i'm tired of it popping..  Thank you
ANSWER: Dear Trevor,

This is not a problem that you need to take lightly, and could be serious.  It is possible that you have a significant instability of the ligaments that attach to the C1 vertebra.  If so then you need to be treated for stability issues.  This is already a very mobile area of the body and contains the upper most portion of the spinal cord and associated nerve roots.  It is not an area you want to have further injury which could possibly lead to permanent damage.

The dizziness you speak of can be caused by multiple issues that would need to be evaluated with a functional examination.  You could have damage to the inner ear, the brain stem, the cerebellum, or just to the joints of the upper neck which can create a balance problem (called proprioception).  Bottom line is that without the examination it is just speculation.

What to do:  If you were in my office I would want to take stress view x-rays of the spine looking for instability.  This means I would have you drop your chin forward to your chest, take an x-ray, have you look at the ceiling and take an x-ray, and possibly with your head to the right and left.  This way I could look at the films and measure any abnormal movement of the bones.

There is also a better imaging technique called DMX...Digital Motion X-ray.  This would be the best way to actually look for instability issues.  I have referred patients out for this test many times to better visualize the spine.  These images will determine if a physical therapy and chiropractic treatment protocol would be appropriate, or if you may need a surgical consult to stabilize the area.

Trevor...you need to get an additional examination and testing.  These things can be missed in the emergency room, and the results of the first cat scan should be followed up on with some form of stress views...either x-rays or the DMX.  Please discuss this with your parents, find a good local chiropractic physician to examine the area and get the cat scans for the doctor to view.  It would be best to find a chiropractor who has post-doctoral training/certifications in sports injuries, orthopedics, or spine trauma.  If you need help finding one in your area, I would be more than happy to help you.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net


---------- FOLLOW-UP ----------

QUESTION: I have a chiropractor but he hasnt really examined the area.  All he has done was try to loosen up my lower back muscles..  Do you think maybe i should go to another chiropractor or something else?? if so, could you help me find a good one?  

Answer
Dear Trevor,

Yes, I do think you should find a different chiropractor.  I can't believe that with your history of trauma and the dizziness, CT findings etc.. that the chiropractor is only trying to work on your low back.  That isn't even your area of complaint.  That's like your mechanic checking the trunk for a problem in the engine.

Did this guy even take x-rays of your neck, or examine the neck?  Unfortunately Trevor, not all doctors are created equal, we need to find you a better one, one who will address your problem and stay on track.

Send me some information:  What city do you live in, and what major city is it close to...make sure that you include the zip codes.  I will go through my referral networks and try to locate a doctor close to you that has been through some post-doctoral training that I know to be of high quality, and send you a list of some doctors in your area.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net