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Journal of Upper Cervical Chiropractic Research

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Upper Cervical Vertebral Subluxation in Multiple Sclerosis Subjects with Chronic Cerebrospinal Venous Insufficiency: A Pilot Study

Sandro Mandolesi, MD Bio, Giuseppe Marceca, MD Bio, Stephen Conicello, DC Bio, Eriece Harris, DC Bio


Journal of Upper Cervical Chiropractic Research ~ September 23, 2013 ~ Pages 65-70



Objective:  The purpose of this study is to evaluate the relationship between Atlas vertebra misalignments identified via radiographs and patients with multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency (CCSVI).


Clinical Features:  Four patients with MS and CCVSI, three women and one man were evaluated according to revised McDonald criteria.  These four patients were compared to a control group of four patients of similar age but with no neuro-degenerative diseases.


Intervention and Outcomes:  This is the first report on Atlas (C1) misalignment in MS patients with CCVSI.  Four patients were evaluated using the Zamboni’s criteria using the following:  Echo Color Doppler (ECD) MyLab Vinco System Esaote, Upper cervical x-ray examination, Myofunctional Map, and Tytron thermal scanning instrumentation. In this study we found different alterations of C1 alignment in the MS patients versus the control group.  Analysis of the x-ray examination permits us to identify a severe rotation and anterior intrusion of C1 in the MS patients with CCVSI. 


Conclusion:  We found not only endovenous congenital malformations, but also external venous compression that blocks drainage flow.  This confirms the validity of our Mechanical Posture Vascular Compressive Block.  We hypothesize that extracranial venous compression is linked to severe misalignment of C1.  We can also catalogue misalignments into two types of degrees: moderate and severe.  This staging permits us to begin to distinguish paraphysiological misalignments from true pathological misalignments. 


Keywords:  Multiple sclerosis, chronic cerebrospinal venous insufficiency, upper cervical, subluxation