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  • Richard R. Fay, DC

Spinal Instability Testing

Updated: Aug 25

Ligament laxity is just that. It’s where the ligament goes lax. Ligaments have this incredible quality. They don’t just break or snap, they stretch, they hyper-stretch. And when they hyper-stretch they cause laxity. For example, if you were to take the ring from a six pack and stretch it, it wouldn’t break, but would deform. And in that deformation, you could never put the can back into it and you would not have a totally 100% functional ring.


Ligaments hold bones in alignment under movement. And when they are damaged, they can no longer hold the bones of the joint in alignment under movement. So, we have what’s called hyper mobility or excessive joint motion. And if we have excessive joint motion, we know it’s due to the laxity in the ligament.

Ligament laxity is not symptomatic. When ligament laxity becomes symptomatic, the clinical term is spinal instability. The spinal motion units are held together by ligaments and when those ligaments become damaged and there’s laxity in the ligaments. There is now excessive motion in the joint, and that causes a motor sensory or a pain problem. If a nerve is influenced negatively, it is called a spinal instability and it can cause the following:

  • motor conditions

  • weakness in the muscles

  • sensory conditions

  • hypersensitivity in an area

  • pain associated in that area


The spine is designed to actually move in very specific, very minute movement patterns that all combine together. It’s both very complex, but very simple at the same time. The thing that holds all these spinal components, all these bones and joints in the right location for that movement pattern are the ligaments. When the ligaments are damaged, there’s excessive motion. It’s that excessive motion which allows the spine to now move in a way that it was not designed to move, which can irritate the nerve, which can cause pain and inflammation.


How to Detect Spinal Instability


It’s not something that you pick up on an x-ray or on an MRI alone. It’s an entity that you pick up when you detect evidence of excessive motion. Remember, the spine can move back and forth. When it moves, that’s called a translation pattern. It also angles when it moves, that’s called an angular pattern. So, we can have abnormal translation or abnormal angulation patterns. The more abnormal the pattern is, the more ligament damage there was.


CRMA is Computerized Radiographic Mensuration Analysis. It’s a spinal ligament injury test that picks up the imaging biomarker of a ligament injury. An imaging biomarker is something that is detectable on an image that leads to a definitive diagnosis. There are 220 specialized ligaments in the human spine, 23 of which are discs. If we have a disc derangement or disc herniation, that’s an imaging biomarker that is picked up on MRI.


The majority of people out there that have chronic pain today have the condition that this test picks up and they’ve just never had it diagnosed. It goes undiagnosed so they are living with chronic pain when they could actually be getting help.


Dr. Fay uses this testing to determine the severity and location of a ligament injury. It is the most significant injury that the spine can undergo. So we only use the highest level of professional and competent radiologists that we can find to perform this service.


At DuPage Health and Physical Therapy the goal of our treatment is to have you pain-free at the end of our care, feeling no chronic pain. To stop your injury from interfering with any activity of your daily living.


If you are interested in finding out more information on CRMA testing give us a call at the office




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