CCJ Instability

By Chris Centeno, MD /

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CCJ instability used to be the most difficult problem we treated. Most patients would get little relief, no matter what treatment was applied. However, I can safely say that now all of that has changed with the addition of our novel CCJ instability procedure that directly targets the lax ligaments responsible for the condition. This morning I'd like to give an update on two long-time patients.

CCJ Instability

There are ligaments that hold your head on, and like any ligament in the body, these can be injured in a traumatic accident or can get loose due to wear and tear and genetic predisposition. A few years back, our Colorado HQ site began looking at a new procedure to directly inject these damaged ligaments. To learn more about this procedure targeting the alar, transverse, and accessory ligaments of the neck, see my video below (from last year):

A Tale of Two Patients

I received an e-mail from one patient over the holidays and performed a follow-up on another this past week. These are both longtime patients who have been difficult to treat due to a myriad of problems. Both were diagnosed with CCJ instability, and both have shown great improvement after years of neck procedures that only provided small amounts of relief. 

Allison is a local acupuncturist with neck, back, wrist, and knee issues. She's about two years out from her CCJ procedure, and I've also treated the other areas with platelets and bone marrow concentrate (same-day stem cell treatment). Here is a picture of her and a report from the ski slopes over the holidays:

"Ok. Here’s the full skinny:
My knee feels amazing!!  Just one spot on the fossa medial to the patellar tendon, but this is the first time I’ve skied without a full fancy schmancy ACL knee brace since a knee injury in 2009. In addition to the overall degeneration you fixed with stem cells, there was always a severe burning, ripping pain as my knee dipped medially. Youhydrodysected an entrapped nerve and voila!  No more ripping burning pain

My lower back…again! No more brace!!!  It feels stable and secure. The pain I most recently mentioned to you was in full force with each turn (you thought some nerves might be entrapped in surgical scar tissue), but otherwise, it’s doing really well. 

Right wrist: also doing really well. It feels strong and other than the feeling of a possible bone spur causing limited ROM, it’s great. I’m so glad I didn’t let the hand surgeon pin it!  He thought I was crazy to try stem cells on my problem. I’m so glad I went with my gut instincts on this. 
Because of my continued right shoulder problem, I couldn’t pole with that side, but if I had, my wrist would have beenpain free. 

My neck post CCJ proceduresis close to normal. A bit stiff now and again, but amazing compared to before the CCJ procedures. I will always ski with my homemade neck brace on out of an abundance of caution, but it’s really more of a security blanket than a necessity. 

My sacrum is awesome!  You worked on that with prolo through stem cells and it seems pretty darned normal too. 

So, each and every place that has been the beneficiary of Regenexx science has been vastly improved by the technology and your good work.

Thanks for all you do!
Allison Suddard"

A Follow-Up 

My second patient is one I have been seeing for many years, again with multiple problems. However, her main disabling issue has always been her CCJ instability. She's also about two years out from her procedure. During her follow-up, one thing stuck out. We had planned a second procedure for this March, after delaying it a few times, but she wanted to treat some new issues caused by a new car accident during that visit instead of repeating the CCJ procedure. In particular, when I asked her what was better since her CCJ procedure, it was the ability to travel over uneven roads. She lives in rural Wyoming with many uneven roads, and even traveling over the suburban roads near our clinic was impossible without reclining or lying down. She was proud that she drove herself to my office. She can also now hike again. Finally, all she does now to make sure her neck is in order is to perform a specific self-adjustment in the morning. Previously, her neck would never "stay in." These might seem like little things, but to someone with CCJ instability, they are life-changing events. 

The 30,000-Foot View of Our CCJ Instability Procedure

This is not a perfect "cure all" procedure. We've seen about 70–80% of the patients treated with between one and four treatments make nice recoveries after everything else had failed. That's being very careful about who we choose for the procedure. 

We've performed about 110 of these procedures to date with no significant complications, so I can now safely say that the procedure is much less invasive and has far fewer complications than upper-cervical fusion.  We also have an open randomized controlled trial for selected patients who fit those inclusion criteria, so some patients are now getting the procedure free of charge. Finally, this is a Colorado HQ-only treatment, meaning we are not authorizing any other Regenexx center to perform this procedure at this time.

The upshot? The new CCJ procedure is proving itself to be very helpful for many patients. It's not a panacea, but no procedure ever is for all patients. Hence, I'll just keep giving periodic updates on the results as time goes on. In the meantime, we'll continue collecting data in our RCT for eventual publication. 

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Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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