Neck Pain after Whiplash? .

Evaluating Motor Vehicle Crash-Associated Neck Pain with Upright MRI

A study by Freeman, published in Brain Injury, July 2010; 24(7-8): 988-994 shows patients with a history of motor vehicle crash-associated neck pain have a substantially higher frequency of cerebellar tonsil ectopia (CTE) than non-traumatic subjects when evaluated with an Upright MRI.

The Upright MRI identified a degree of gravity dependent instability in the trauma group that was not observed in the non-trauma group.

This study indicates that cerebellar tonsillar ectopia is substantially more prevalent in whiplash-injured neck pain patients than in neck pain patients with no recent history of trauma.

Upright position MRI appears to increase the sensitivity to CTE over recumbent MR imaging by 2.5 times.

Spinal Instability Neoplastic Index

If you or somebody you know has a spinal tumor consider the following information.

This information is taken directly from a report published in the Journal of Clinical Oncology, Volume 29 Number 22 August 1, 2011 page 3072-3077.  Every credit goes to the authors, the lead of which is Daryl R. Fourney, M.D.

The Spine Oncology Study Group (SOSG) defines spine instability as the “loss of spinal integrity as a result of a neoplastic process that is associated with movement-related pain, symptomatic or progressive deformity and/or neural compromise under physiologic loads.”

The SOSG used an evidence-based process was used to develop a scoring system, the Spine Instability Neoplastic Score (SINS), to help determine whether a metastatic lesion should be considered for surgery.  In this classification system six individual component scores are added together to give a predictive value to tumor-related instability:

Spine location

Junctional (occiput-C2, C7-T2, T11-L1, L5-S1)                     3

Mobile (C3-C6, L2-L4)                                                          2

Semirigid (T3-T10)                                                               1

Rigid (S2-S5)                                                                        0


Yes                                                                                     3

Occasional pain but not mechanical                                 1

No                                                                                      0

Lesion bone quality

Lytic                                                                                      2

Mixed (lytic/blastic)                                                              1

Blastic                                                                                   0

Radiographic alignment

Subluxation/translation present                                        4

De novo deformity (kyphosis/scoliosis)                              2

Normal alignment                                                              0

Vertebral body collapse

>50% collapse                                                                  3

<50% collapse                                                                  2

No collapse with > 50% body involved                            1

None of the above                                                            0

Posterolateral involvement of the spinal elements

Bilateral                                                                            3

Unilateral                                                                          1

None of the above                                                            0

A score of 0 to 6 denotes stability, 7 to 12 denotes indeterminate instability, and 13 to 18 denotes instability. A surgical consultation is recommended for patients with SINS scores greater 7.

Colin Buchanan, M.D. joins CDA Spine & Brain, PLLC. Accepting appointments as of September 1, 2014.

Colin buchanan website

Colin C. Buchanan, MD is a fellowship-trained neurosurgeon joining the CDA Spine and Brain practice. Dr. Buchanan specializes in the management of complex spinal disorders, neurosurgical oncology, and minimally invasive surgery (MIS).  He is accepting appointments as of September 1, 2014.

Dr. Buchanan received his undergraduate degree from Denison University in Granville, Ohio. He attended Wayne State University School of Medicine in Detroit, where he was elected to the Alpha Omega Alpha Honor Medical Society. After medical school, Dr. Buchanan completed a general surgery internship followed by neurosurgery residency at the University of California, Los Angeles. During his residency, he received extensive training in the treatment of brain and pituitary tumors, functional neurosurgery and stereotactic radiosurgery, and traumatic brain injury. After residency, he completed a one-year fellowship in spine surgery at the Cleveland Clinic where he received training in both orthopedic and neurosurgical spine surgery from world-renowned experts.

Dr. Buchanan has conducted research on health care quality improvement. He is dedicated to continued research and advanced techniques in spine surgery, including neuronavigation. He has additional interests in neurosurgical education and has participated as an instructor at the annual Cleveland Spine Review course. He is a member of the American Association of Neurological Surgeons (AANS), the Congress of Neurological Surgeons (CNS), and the North American Spine Society (NASS).

Dr. Buchanan is committed to achieving the best functional results for his patients. He uses both surgical and non-surgical treatment approaches to address disorders of the spine and brain. His clinical interests include: lumbar degenerative spine, cervical degenerative spine, adult spinal deformity, complex spinal reconstruction, spinal tumors, motion-preserving spine surgery, minimally invasive spine surgery, spine and brain trauma, brain tumors, pituitary tumors, stereotactic radiosurgery, hydrocephalus, and trigeminal neuralgia.

When not at work, he enjoys spending time with his wife and son. He is an avid downhill skier and raced high school slalom and giant slalom in Michigan. He also enjoys golf. The Buchanan family looks forward to outdoor fun in Coeur d’Alene.