Subluxation of the vertebral joint

Subluxation of the vertebral joint is a serious health condition that poses the risk of paralysis in vertebrates. Making the diagnosis of "subluxation" in animals and humans requires direct evidence that XXX, usually by plane x-ray, CT scan, or MRI imaging.

Cervical Spine

Subluxation caused by instability of the cervical spine

Congenital problems

Down syndrome. Achondroplastic dwarf. (Reilly CW. Choit RL.Transarticular Screws in the Management of C1-C2 Instability in Children.ournal of Pediatric Orthopedics. 26(5):582-8, 2006 Sep-Oct. UI: 16932095.)

Acute Trauma

(Gavin Watson and Vipul Upadhyay. Paediatric cervical spine injuries: An audit of 22 acute injuries and literature review • ARTICLE Injury Extra, Volume 36, Issue 11, November 2005, Pages 469-474)

specific injuries

unilateral cervical facet injuries.(Marcel Dvorak, Bizhan Aarabi, Raja Rampersaud, Mitchel Harris, Michael Fehlings, David G. Schwartz, Brian Kwon and Charles Fisher: Outcomes of Operative versus Nonoperative Treatment of Unilateral Cervical Facet Fracture Subluxations.The Spine Journal, Volume 6, Issue 5, Supplement 1, September-October 2006, Pages 39S-40S )

Infection and inflammation

(Chad Galer, Eric Holbrook, John Treves and Donald Leopold.Grisel's syndrome: A case report and review of the literature • SHORT COMMUNICATION International Journal of Pediatric Otorhinolaryngology, Volume 69, Issue 12, December 2005, Pages 1689-1692) (Alessandra Rinaldo, Vanni Mondin, Carlos Suárez, Eric M. Genden and Alfio Ferlito.Grisel’s syndrome in head and neck practice • REVIEW ARTICLE Oral Oncology, Volume 41, Issue 10, November 2005, Pages 966-970)

Result of chronic arthritis

(Dieu-Donné Ouédraogo, Elisabeth Palazzo, Mireille Nlomé-Nzé, Nathalie Somogyi, Magali Ballard, Gilles Hayem and Olivier Meyer. Predominant cervical involvement in patients with psoriatic arthritis: report of two cases • SHORT COMMUNICATION Joint Bone Spine, In Press, Corrected Proof, Available online 21 July 2006)

Special considerations in infants and children

"wry neck"

Subluxation of the first of the cervical vertebrae (C1-C2) can cause this condition. When displacement of the joint is one-sided (unilateral) , there is typically a "cock-robin" deformity. Correction may require surgery, but has been reported, in some cases of acute trauma to older children, to be brought about by a combination of traction and prolonged television watching!. Neurosurgeons have warned that the diagnosis may be difficult to make on imaging: the angle of the jaw can overlay and obscure the area on plain film, MRI must sometimes be done at more than one angle of cut, and - once non-Titanium metal is in place for traction screws, this imaging modality (currently considered optimal) may not be able to be used at all for fear of movement of the hardware by the magnet.(B. HOFFMAN, G. KAAR:Traction and television for reduction of unilateral childhood rotatory atlanto-axial subluxation. British Journal of Neurosurgery.Volume 13, Number 1/February 1, 1999.10.1080/02688699944221. pages71-72)

In young children, halo fixation has been used to correct the condition. (Caird, Michelle S. MD*; Hensinger, Robert N. MD*; Weiss, Nicole CO†; Farley, Frances A. MD*. Complications and Problems in Halo Treatment of Toddlers: Limited Ambulation is Recommended.Journal of Pediatric Orthopedics. 26(6):750-2, 2006 Nov-Dec. UI: 17065939)

Lumbosacral spine

(William Sears:Posterior lumbar interbody fusion for lytic spondylolisthesis: restoration of sagittal balance using insert-and-rotate interbody spacers • ARTICLE The Spine Journal, Volume 5, Issue 2, March-April 2005, Pages 161-169)