C1–C2 SUBLUXATION – MYTH OR REALITY OF ACUTE TORTICOLLIS IN CHILDREN?
https://doi.org/10.14531/ss2008.4.8-12
Abstract
Objective. To study acute pathological conditions of the cervical spine in children. Material and Methods. 200 case records of patients with acute torticollis were analyzed. Majority of patients having neck pain and abnormal head position were not diagnosed with C1 subluxation. MRI investigation performed in 4 patients one day after the disease onset has shown changes in uncovertebral joints of C2–C3 or C3–C4. Results. A forced position of the head in 182 children (91.0 %) was characterized by predomination of head bending over neck rotation. Out of 149 children with predomination of bending 89 patients (49.0 %) complained of right-sided neck pain accompanied by left-sided head bending; 41 (22.5 %) had a contrary situation – left-sided neck pain and right-sided head bending; and 19 (10.4 %) had a fixed head position and neck movement incapability. Disorders of sagittal profile of the spine with loss of lordosis or significant kyphotization were detected in more than 70.0 % of children. Conclusion. The obtained findings along with the absence of changes in atlantoaxial segment require further investigations of causes of acute torticollis in children.
About the Authors
Aleksandr Vadimovich Gubin
St. Petersburg State Pediatric Medical Academy
Russian Federation
Russian Federation
Eduard Vladimirovich Ulrikh
St. Petersburg State Pediatric Medical Academy
Russian Federation
Russian Federation
Anatoly Nikolayevich Yalfimov
St. Petersburg State Pediatric Medical Academy
Russian Federation
Russian Federation
Aleksey Ivanovich Taschilkin
St. Petersburg State Pediatric Medical Academy
Russian Federation
Russian Federation
References
1. Мозгунов А.В. Диагностика и лечение острого атлантоаксиального ротационного подвывиха у детей и подростков: Автореф. дис.. канд. мед. наук. Курган, 2004.
2. Никитин М.Н. Об одной из причин ротационного подвывиха атланта // Ортопед. травматол. 1965. № 4. С. 47–52.
3. Alanay A., Hicazi A., Acaroglu E., et al. Reliability and necessity of dynamic computirized tomography in diagnosis of atlantoaxial rotary subluxation // J. Pediatr. Orthop. 2002. Vol. 22. P. 763–765.
4. Fielding J.W., Hawkins R.J. Atlanto-axial rotatory fixation. (Fixed rotatory subluxation of the atlantoaxial joint) // J. Bone Joint Surg. Am. 1977. Vol. 59. P. 37–44.
5. Fiorani-Gallotta G., Luzzatti G. [Lateral subluxation and rotatory subluxation of the atlas] // Arch. Orthop. 1957. Vol. 70. P. 467–484.
6. Maigne J.Y., Mutschler C., Doursounian L. Acute torticollis in an adolescent: case report and MRI study // Spine. 2003. Vol. 28. P. E13–E15.
7. Maheshwaran S., Sgouros S., Jeyapalan K., et al. Imaging of childhood torticollis due to atlanto-axial rotatory fixation // Childs. Nerv. Syst. 199 5. Vol. 11. P. 667–671.
8. Martinez-Lage J.F., Martinez Perez M., Fernandez Cornejo V., et al. Atlanto-axial rotatory subluxation in children: early management // Acta Neurochir. (Wien). 2001. Vol. 143. P. 1223–1228.
9. Mercer S., Bogduk N. Intra-articuar inclisions of the cervical synovial joints // Br. J. Rheumatol. 199 3. Vol. 32. P. 705–710.
10. Mercer S., Bogduk N. The ligaments and anulus fibrosus of human adult cervical intervertebral discs // Spine. 199. Vol. 24. P. 619–628.
11. Hicazi A., Acaroglu E., Alanay A., et al. Atlantoaxial rotatory fixation-subluxation revisited: a computed tomographic analysis of acute torticollis in pediatric patients // Spine. 2002. Vol. 27. P. 2771–2775.
12. Van Holsbeeck E.M., MacKay N.N. Diagnosis of acute atlanto-axial rotatory fixation // J. Bone Joint Surg. Br. 1989. Vol. 71. P. 90–91.
Review
For citations:
Gubin A.V., Ulrikh E.V., Yalfimov A.N., Taschilkin A.I. C1–C2 SUBLUXATION – MYTH OR REALITY OF ACUTE TORTICOLLIS IN CHILDREN? Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2008;(4):008-012. (In Russ.) https://doi.org/10.14531/ss2008.4.8-12
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