Urinary Symptoms and CCI

What's the most likely cause of urinary frequency and urgency in a craniocervical instability patient — and when does it actually call for detethering surgery? In this Facebook Live, Dr. Chris Centeno of the Centeno-Schultz Clinic breaks down a real case that prompted the topic: a patient told he needed an occult tethered cord release for back pain and urinary symptoms, whose MRI actually showed a clear L5-S1 problem instead. Dr. Centeno explains how urodynamic testing and SSEP (somatosensory evoked potential) studies work, and why both can come back abnormal in patients with ordinary low back issues — not just tethered cord — making it easy to end up recommending an irreversible neurosurgical procedure when a much less invasive treatment would work. He walks through how irritated sacral nerves at L5-S1 can cause bladder symptoms without any back pain at all, what to look for on MRI (disc bulge, multifidus muscle atrophy), and why treating the low back with a caudal epidural of platelet growth factors is often the right first step before ever considering detethering. The rest of the session is an extensive live Q&A covering what causes dizziness and balance issues when looking down, dilated pupils and CCI, diet and PICL preparation, whether posture/curve correction should come before or after PRP, POTS symptoms and the vagus nerve, multifidus muscle rehab, whether instability severity correlates with symptom severity (it often doesn't), ACE inhibitors affecting stem cell cultures, international travel timing after PICL, vagus nerve regeneration, posterior PRP and CCI subtype-specific diagnosis, PICL outcomes in EDS patients, BMI and airway management improvements, the neck-to-low-back connection, posterior prolotherapy injection counts, autoimmune disease and PICL outcomes, hydrodissection frequency, bone spurs, whether CCI can be inherited, GI issues and the vagus nerve, causes of brain fog, and tips for improving stem cell quality before a procedure. This discussion draws on Dr. Centeno's ongoing clinical work treating craniocervical instability at the Centeno-Schultz Clinic, part of the Regenexx network of interventional orthobiologics providers. If you found this helpful, like, comment, and subscribe so you don't miss future live Q&As, and reach out to the clinic if you have questions about your own symptoms or care. 🔔 If you find this content helpful, please like, comment, and subscribe to stay informed.    / @centenohome   To schedule a telemedicine or in-person visit, call +1-303-429-6448 or email us at icabral@centenoschultz.com. Dr. Centeno also answers questions on his Reddit thread at   / picl   Join him for weekly Facebook Lives at   / centenoschultzclinic   to learn more. Download Dr Centeno's book on craniocervical instability at https://centenoschultz.com/craniocerv... Join CCI Communities: PICL SubReddit: https://www.reddit.com/r/PICL/?rdt=58942 PICL Facebook Group:   / ccjpicl   Follow us for updates and news: Website: https://centenoschultz.com/ https://regenexx.com/ Facebook:   / centenoschultzclinic   Instagram:   / centenoschultzclinic   LinkedIn:   / chris-centeno-m-d-b6838024   Centeno-Schultz Clinic 403 Summit Blvd Suite 201 Broomfield, CO 80021 303-429-6448 Timestamps: 1:12 Urodynamics, neurogenic bladder, and why patients often get unnecessary detethering surgery 5:11 What an SSEP actually measures, and how L5-S1 nerve irritation causes bladder symptoms 10:27 Diagnosing and treating the low back first, and when detethering surgery really makes sense 11:30 Q&A: dizziness and balance, dilated pupils, diet before PICL, and curve correction timing 19:38 Q&A: POTS and CCI, the pre-screening process, multifidus rehab, and detethered cord patients 24:44 Q&A: instability severity vs. symptom severity, ACE inhibitors and stem cells, and international travel after PICL 29:40 Q&A: vagus nerve regeneration, posterior PRP diagnosis specificity, EDS outcomes, and BMI/airway updates 34:34 Q&A: neck-low back connection, posterior prolo injection counts, autoimmune disease, and hydrodissection frequency 39:16 Q&A: bone spurs, CCI heritability, brain fog causes, stem cell quality tips, and closing questions