Summary by Utah Sports and Wellness

Link to Original Article: https://pubmed.ncbi.nlm.nih.gov/32655279/

Clinical Medicine Insights, Volume 13. July 2020. Lincoln University College, Malaysia. 14 References.

 

This report describes the management of a 10-year-old boy with episodes of Torticollis:

  • Open mouth radiograph and computed tomographic (CT) scan gave a diagnosis of atlantoaxial rotatory subluxation (AARS).
  • There was no improvement in clinical status following 6 months of halter traction and neck bracing.
  • Seven months after the onset of symptoms, a multidisciplinary spine team referred the patient to a chiropractic clinic.
  • Following five months of chiropractic treatment, the patient was asymptomatic with nearly full range of neck movement.

AARS is the loss of normal alignment and stability of the first and second cervical vertebrae:

  • Atlantoaxial subluxation is extremely rare in individuals with no predisposing factors.
  • Rotatory subluxation is often missed in emergency medical settings in patients with neck pain and torticollis.
  • Standard treatment involves neck traction, collar immobilization, and anti-inflammatory medications.
  • The most important factor for success us early diagnosis and timing of treatment.

 

Other Key Points & Case Report:

  • The cervical spine in children is hypermobile compared to adults.
  • Non-traumatic instability occurs almost exclusively during childhood.
  • A 10-year-old boy woke up with painful torticollis, locking his head in right rotation. He had no prior traumatic or infectious events.
  • His family doctor diagnosed acute torticollis and prescribed acetaminophen. After two weeks of no change, the child was referred to the local hospital for an orthopedic assessment.
  • Open-mouth radiographs revealed atlantoaxial rotatory subluxation. The child then underwent chiropractic treatment three times per week for 4 weeks.
  • Afterwards, his pain was significantly relieved and his cervical mobility was restored by 70%.