Case: evaluation of the position of the Atlas with 2D and 3D CT before and after therapy.

Objective of the case

The objective was to check the mechanical changes of the Atlas position in a patient before and after the application of the AtlasPROfilax® Method for Atlas correction.

Technology used

A high-resolution iCat 3D model scanner was used that produces .2mm voxel images in a very short time with low radiation and little patient exposure. The data obtained were analyzed based on the DICOM3 program. The scanner has a 12 bit grayscale resolution as far as its quality is concerned, providing also colored 3D reconstructions.

Main features:

X-ray source: High frequency, constant potential, 120 kVp fixed anode, 3-8 mA...
X-ray beam: Cone
Focal point: 0.5mm
Image detector: Amorphous silicone flat panel, 20 cm x 25 cm
Grayscale: 12 bit
Voxel size: 0.4 mm (typical), 0.2 mm (minimum)
Image acquisition: individual 360-degree rotation
Scanning time: 20 seconds in standard
Patient position: sitting
Scanner dimensions: 17 cm (diameter) x 13 cm (height)
Primary Reconstruction: 1.5 minutes for 20 second scan
Secondary Reconstruction: Real Time

Procedure used

The patient was framed by chin, forehead and head attachments limiting any head movement. The fixation was the same in both the pre- and post-therapy shots. A laser guide in the form of a frontal cross was used on the face and side (cheekbone) to accurately measure the shots. A standard scan was launched with coronal, sagittal and axial cuts. The images were reconstructed in 2D and 3D and the two images were compared.

Performing AtlasPROfilax® therapy

The patient was treated with AtlasPROfilax® therapy, which consists of highly specialized vibropressure on the short muscles of the nape. Prior to the therapy, the patient had undergone a tomographic scan. Two months later, the patient underwent another tomographic study under the same conditions and according to the same parameters as the first one to determine variations and changes in the position of the Atlas by comparing both imaging tests.

Results

Before therapy

After therapy

Before therapy

Note in the axial section the rotation of the Atlas with respect to the natural orthogonality. In the coronal section, a clear asymmetry can be seen as only one of the two transverse apophyses of the Atlas is shown (the left one), the other transverse apophyses being relegated by the rotation to a plane that the image does not show. The mechanical position of the atlas is not correct, it suffers from a malrotation with craniocaudal deviation.

Diana Cardenas PRE Watermark dibujo — Pre-therapy axial and coronal cuts

After therapy

After the AtlasPROfilax® therapy a very clear change in both planes can be observed. The previous malrotation of the Atlas has normalized and disappeared (see blue line). At coronal level the left process has disappeared as the malrotation has normalized. Unlike the previous shot, the coronal section now shows the lateral masses of the Atlas without only one of the transverse processes appearing.

Diana Cardenas Post Watermark dibujo — Post-therapy axial and coronal sections

Odontoid changes vs. lateral masses

Before therapy

Note how the malrotation of the Atlas, prior to therapy, involves a translation or displacement of it creating an asymmetry between the distance of the lateral masses of the Atlas with respect to the odontoid process. The distance is almost double from one side to the other.

After therapy

Note the change in distance between the odontoid process and the lateral masses in the Atlas. The distance is, after the correction of the Atlas with AtlasPROfilax®, practically the mass and in any case much better than in the image taken before the application of the therapy.

Clinical and postural changes

On the clinical side, the patient showed several significant improvements after the correction of the Atlas.

Improved posture:

The Atlas correction changes the center of gravity by improving downward fascial translation and the natural compensatory balance between the various centers of gravity of the spinal segments, the pelvic girdle, and the foot support. See in the example the postural change in the patient.

Improvement in the midline dental line in closure

The dental midline and its deviations are an indicator and predictor of temporomandibular joint disorders (see Dr. Gutierrez's study on the "Effect of atlasprofilax® therapy on symptoms related to temporomandibular dysfunction, bruxism and the relationship of dental midlines"). In this case, the patient obtained an improvement in the correlation (before and after therapy) of the dental midline.

Improved dental line in opening

The improvement in mouth opening and midline was also clear after the application of AtlasPROfilax® therapy.