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There is new hope for Multiple Sclerosis sufferers, and it may be related to the Upper Cervical Spine.  If you haven’t heard of the term CCSVI, you will soon.  Three years ago Dr. Paulo Zamboni of the University of Ferrara in Italy, hypothesized that an abnormality in blood and/or Cerebro-Spinal Fluid (CSF) drainage from the brain and spinal cord may contribute to nervous system damage in M.S.  The term he uses for this phenomenon is called Chronic Cerebro-Spinal Venous Insufficiency, or CCSVI.   This can be visualized as a physical blockage of blood flow through functional MRI or Doppler Ultrasound, and the degree of blockage can be quantifiable (measured in numbers). Other researchers and health experts are now getting behind Zamboni’s hypothesis, as new research has emerged and been scheduled.

So far, the research has found a higher frequency of CCSVI in M.S. patients.  Furthermore, a history of head trauma has been correlated to a backup of CSF which can lead to M.S., Parkinson’s, and Alzheimer’s.  A recent study published in the Journal of Phlebology concluded that this venous insufficiency likely occurs from a physical blockage in the cervical spine.  Another recent study, contributed mainly by Dr. Scott Rosa, showed that Upper Cervical Chiropractic care can decrease the pressure and restore proper CSF flow and drainage from the brain.

While the causation of CCSVI is becoming clearer, the current medical treatment is a bit muddled.  The treatment technique utilized by Zamboni is called Percutaneous Balloon Angioplasty (PTA), and remains highly controversial.  Some research points out that this procedure has led to a relatively high percentage of complications, including need for multiple procedures, and in a few cases death.  On the other hand, there is research that supports the relative safety of this procedure when weighing the risks vs. the potential benefits, and generally considers it effective.  Other doctors have used a stent or a combination of the two, with mixed results.  An emerging natural treatment method for CCSVI, stemming from the research noted above, is Upper Cervical care.  What gives this particular approach the edge over others is that there are no side effects.

Upper Cervical care seeks to correct the alignment of the head & neck, which is a critical part of the body as it relates to health.  The top two bones in the neck (C1,C2) sit directly underneath the brain stem, and provide protection to the spinal cord and related blood vessels, including the internal jugular veins.  A misalignment in this area can create a torqueing of the top of the spinal cord, thus compressing the venous structures in the top of the neck, ostensibly interfering with blood and cerebrospinal fluid drainage from the brain.

Multiple Sclerosis is a disease that involves an immune system attack against the Central Nervous System (brain, spinal cord, and optic nerves).  This attack causes a breakdown in the myelin sheath which serves as a protector and conductor of the nerve tissue.   When any part of the myelin sheath is damaged or destroyed, nerve impulses traveling to and from the brain via the spinal cord are distorted, producing a variety of symptoms including progressive incoordination, vision impairment, spasticity, fatigue, and cognitive dysfunction among others.  This emerging CCSVI hypothesis contradicts the early predominant theory that this demyelination is a result of an autoimmune cascade.  The significance of this is that most current M.S. medications are targeted at the immune system, under the assumption that the autoimmune reaction is always the principle causative factor.  With the emergence of the CCSVI hypothesis and supporting research, the causation of M.S. is now very much in question.  Could there be more than one cause?

Clearly, more research is needed but the evidence thus far cannot be understated.  This is a huge breakthrough for those suffering from M.S. and may just in fact be the start of a groundbreaking discovery in health care.

By Noah Kaplan, D.C.

Advanced Upper Cervical


Burton JMAlikhani KGoyal MCostello F, et al.  Complications in MS patients after CCSVI procedures abroad (Calgary, AB). Can J Neurol Sci. 2011 Sep;38(5):741-6.

Hubbard, David.  Clinical Improvement after Extracranial Venoplasty in Multiple Sclerosis.  Journal of Vascular and Interventional Radiology.  Volume 23, Issue 10 , Pages 1302-1308, October 2012.

Patti FNicoletti ALeone CMessina SD’Amico ELo Fermo S, et al. Multiple sclerosis and CCSVI: a population-based case control study. PLoS One. 2012;7(8):e41227. doi: 10.1371/journal.pone.0041227. Epub 2012 Aug 3.

Radak Djordje, et al. Incidence and distribution of extravascular compression of extracranial venous pathway in patients with chronic cerebrospinal venous insufficiency and multiple sclerosis. doi: 10.1177/0268355513486638. Phlebology May 9, 2013 0268355513486638.

Weinstock-Guttman BRamanathan MMarr KHojnacki DBenedict RH, et al.  Clinical correlates of chronic cerebrospinal venous insufficiency in multiple sclerosis. BMC Neurol. 2012 May 15;12:26. doi: 10.1186/1471-2377-12-26.–multiple-sclerosis-canada-launching-clinical-trial-of-controversial-treatment-developed-by-zamboni
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