My Mal-alignment Syndrome Update

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I am happy at my progress in dealing with Malalignment Syndrome.  I still struggle with Malalignment in my thoracic and cervical portions of my spine. But my struggle is less severe than before the SI Fixation surgery. When I go to the chiropractor now it is for the area between my shoulders and for my neck.  The compensatory curves are typical conditions of malalignment syndrome. Rarely are my lumbar segments ever adjusted and if they are, extreme caution and detail by my chiropractor is used in his adjustments as there can be no thrust against the iliums whatsoever. A thrust against the iliums is a direct violation of post-operative SI protocol and a sure way to cause a loosening of the screws. My chiropractor never has to touch the iliums as my bi-lateral SI joints are always right where they should be in complete neutral alignment with an on-going thank you to Dr. Weiss and Vicki Sims, PT.  I simply cannot be happier. It is as though a surgical intervention never occurred.  I have no sign or any symptoms of 4 screws in my bi-lateral SI joints.  When most of us are tired of life and sick of people screwing around with us in a negative way, then please pardon my expression but  I absolutely want to say in a positive way this time around: “It feels good to be screwed!”

Here is another wonderful teaching video of Vicki Sims, PT at Gainesville Physical Therapy explaining malalignment syndrome and  SI dysfunction.  Here is link to a research article related to the below video:

I wanted to know how  my entire spine was doing since the SI Fixation Surgery on 1-17-13. So I asked Dr. Scott Sheldon, DC of  Dwyer Chiropratic  to take the following full spine x-rays on May 8th, 2013:

Dr. Sheldon’s findings and interpretation of my standing full AP and lateral x-ray views:   “Kim has no measured leg length discrepancy. There is no rotation of her sacrum.  The even leg length and no SI joint misalignment in the anterior or posterior direction is really good. To be that close to neutral in all directions is really tough to do. There is 5 mm of internal rotation of her right SI. The measurement for the rotation is taken off of the pubic symphysis. So there is a slight amount of room for error on the measurement. However, 5 mm of error is highly unlikely. The obturator images on the x-ray correlate with an internal SI listing on the right. There is decreased disc space on her lateral x-ray at the L5-S1 level. There is a mild left list beginning at T11. There is a mild right list beginning at T4. There is a slight decrease in her cervical lordosis.”
1. Degenerative Disc Disease at L5
2. Decreased cervical curve

My personal opinion of my own x-rays: I am doing extremely well in maintaining my spine despite what I have been through in the last 20 years.  Besides the prior extra-articular SI dysfunction and L5-S1 mass herniation,  I did have 3 major whiplashes. One of those whiplashes 20 years ago, was from being thrown from a horse and landing in a field on my neck between my shoulders. I was blessed to not have broken my neck. This diagnostic test of recent time does show only mild degeneration Cervical Bone Scan 10-4-11 

To help my cervical curve, I sleep over a rounded cervical pillow. When I travel in a car for long distance or fly on an airplane, I use the ProCare Vista Cervial Collar  for additional neck support to prevent my head from falling forward or to the side which stresses my neck more. This collar for me is so much more comfortable than soft collars as I can adjust the height and I’m not being choked across the front of my throat. I have a thinner long neck and getting a soft collar to fit right was very difficult for me.  And my neck is not any weaker with the intermittent use of this product. I simply prevent getting a headache by wearing this Vista Collar  if my neck has become too stressed by travel.

Regarding my degenerated L5-S1 disc space, it is what it is. Nothing can change its condition and I may need to face a spine surgery in the future should it further degenerate and then compress a nerve root. But for now, it is not a pain generator and I have no nerve issues pertaining to that disc space. Believe me when I tell you, my referred lumbar pain does not exist any more  since my SI fixation surgery because my right SI joint is no longer in an up-slipped position which felt like a constant jamming of my lumbar. No more stress to the iliolumbar ligament 

With chronic sacroiliac joint instability(my left joint), the contralateral (my right joint) sacroiliac joint and the pubic symphysis may destabilize. Now this destabilization of the pubic symphysis should re-stabilize over time as the muscles are reconditioned in the SI post-operative protocol.  To help my pubic symphysis alignment,  I do the Pubic Bone Correction as follows per Vicki Sims’ protocol after SI surgery: Lie on your back. Bend both your knees up and place your feet flat on the table or bed. Place and squeeze a ball or any solid object between your knees. Hold for 5 seconds. Do 3 repetitions.

To help my neck and thoracic regions, I keep regular chiropractic adjustments, regular medical massage, and I now use the thoracic roll. These regions are now easier to maintain, or should I say, they are affected to a lesser degree (less pain) since I have stability to the root of my spine in my fixated SI joints.  What pain I do get is very mild and only in the muscles.  I have no direct joint pain. I do these type of exercises that you see here in this wonderful, instructional video posted on demonstrating the use of the thoracic foam roller. The only difference for me is that I use a 4 inch firm roller instead of a typical 6″ as shown here in these video:

I will continue to update in the future as I have information to share. However, in the meantime may I direct my readers to a concurrent medical journey that I am on for my Proximal Tibiofibular Joint, please see this link to the beginning of my blogs.

Here is a link to my next Malalignment Category Blog: Malalignment Syndrome Diminishing





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Dr. Trumble, My Upper Extremity Surgeon, at Bellevue Hand Surgery