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well welcome everyone and happy monday welcome to another episode of youamp;#39;ve got the power iamp;#39;m your host dr jason deich and of course i am here with chief medical officer of the centeno schultz clinic in boulder broomfield colorado dr chris centeno good to see you doc good to see you jason all right everyone we are back to talking about picl procedures uh this did today weamp;#39;re actually speaking about the fact that many of you may not be aware that there are two types of picl procedures there is the above the atlas below the atlas today doc letamp;#39;s break down the differences between the two who needs which one when letamp;#39;s break it down yeah so just uh to give everyone a 30 000 foot view this is the picl procedure which is injecting the ligaments that hold the head on and these are patients who have had an injury to those ligaments and who are pretty disabled from that injury theyamp;#39;ve got craniocervical instability so the picl procedure involves