Abstract
Patients suffering from chronic pain and dysfunction after acceleration/deceleration trauma to the cervical spine often present reliability problems. This is partly due to inadequate possibilities of diagnosing soft tissue structures in this area.
A new diagnostic methodfunctional magnetic resonance imaging (fMRI)-has made it possible to detect injuries in ligaments and capsules at the craniocervical junction. Not only do these structures stabilize the head during rotational movements, but they also contain receptors of the central nervous system, and thus have the most important function in position perception (i.e., proprioception) and movement control. The late onset of symptoms in this patient group can now be explained by the functional stenosis of the spinal cord and brainstem due to scar formation around the dens axis after injury. Modern neurophysiology can now explain the background of the generalized and complex picture of chronic pain and muscular and cognitive dysfunction.
This new knowledge has prepared the way for more specific therapy in patients suffering from craniocervical instability symptoms and pain from disks and facet joints in the cervical spine after whiplash trauma.