Understanding Clivoaxial Angles: Are My Measurements Standard?
I am a 43-year-old woman, standing 5 feet 2 inches tall and weighing 100 pounds. There's a possibility that I have a connective tissue disorder, such as Ehlers-Danlos syndrome. My current medication regimen includes pregabalin and mirapex. I experience a range of health issues, notably orthostatic hypotension, severe dysphasia, high muscle tension, diaphragmatic dysfunction, rib pain, and chronic headaches. Additionally, I have moderately severe emphysema in the upper regions of my lungs and mild emphysema in the lower parts, which is compounded by severe hyperinflation and pulmonary hypertension, all of which have placed a strain on the right side of my heart. As a former smoker, I am currently facing significant functional impairments, including episodes of temporary paralysis in both my arms and legs. Since I was 18, I have been undergoing physical therapy to address the burning sensations in my neck. Recently, I underwent a standing MRI with my head in a flexed position. Due to restrictions on shoulder movement, I wasn't able to extend my neck backward as far as I typically can. The measurements I obtained show a clivoaxial angle of 131° in a neutral position, 121° when flexed, and 167° in extension. I’m curious if these angles fall within the normal range. I am also aware of some pre-existing conditions, including bulging discs and stenosis in my cervical spine between C4 and C7. If anyone could shed light on whether these angles are considered usual or if they indicate a concern, I would greatly appreciate it.
Answers (1)
9/10/2025, 10:50:42 PM
OpenHealth AI
Your measurements of the clivoaxial angle in different neck positions can provide insights into potential underlying issues, especially given your complex health background. Let’s break this down.
Main Points:
- Clivoaxial Angle: Your measurements show a normal clivoaxial angle in extension (167°) and a decreased angle in flexion (121°).
- Potential Concerns: Decreased angles might indicate issues with cranio-cervical stability, especially considering your connective tissue concerns and cervical spine conditions.
- Understanding Your Health Context: Your chronic symptoms and existing spinal issues may influence these measurements and their implications.
Explanation:
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Normal Ranges:
- Typically, clivoaxial angles range from about 130° to 160° in a neutral position. Your neutral measurement of 131° is at the lower edge of normal, whereas the flexed position shows a significant decrease.
- Extension angles should ideally be larger than the neutral position, and yours (167°) indicates good ability to extend, which is a positive sign.
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Implications of Low Angles: A decrease in the clivoaxial angle when flexed (to 121°) might suggest vulnerability or instability in the relationships between the skull and the cervical spine. This is particularly relevant given your concerns about connective tissue disorders.
Next Steps:
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Monitor Symptoms: Keep track of any changes in your symptoms, especially related to neck pain, headaches, or neurological symptoms (like your episodes of temporary paralysis).
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Posture and Movement: Practice gentle neck exercises and stretches that are safe for your situation. This may help maintain range of motion without undue strain.
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Consultation with a Specialist: It’s crucial to discuss these MRI findings and the significance of your clivoaxial angle variations with a spine specialist or neurosurgeon familiar with connective tissue disorders. They can provide guidance tailored to your specific conditions and needs.
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Physical Therapy Focus: Continue with physical therapy, emphasizing exercises that promote neck stability and management of symptoms. Ensure your therapist is aware of your recent MRI results and ongoing health issues.
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Lifestyle Considerations: Focus on a supportive lifestyle that includes adequate hydration, nutrition, and possibly breathing exercises to assist with emphysema and managing pulmonary and neurological symptoms.
Your situation is complex, so each step taken should be carefully considered in conjunction with healthcare professionals involved in your care. Let me know if you need guidance on specific exercises or symptom management strategies.
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