Treatment of atlantoaxial rotatory subluxation with chiropractic manipulation and spinal adjusting instrument in children
YU Hong
WU Wen-wen
HOU Shu-xun
ZHOU Zhong-hua
HE Jian-jun
WANG Qiang
Shawn He
Christopher Colloca
Abstract：Objective To investigate the effectiveness of chiropractic manipulation with spinal adjusting instrument in treating children with atlantoaxial rotary subluxation.Methods This was a retrospective analysis for the cases from July 2004 to August 2014 in our hospital. There were 37 cases ( 27 males and 10 females ), and the age ranged from 3.5 to 12 years ( mean 7.9 years ). Clear history of upper respiratory tract infection before the onset was found in 8 children ( 21.6% ); while a clear history of head and neck trauma accounted for 13 ( 35.1% ). Treatment time was ranging from the day of the onset to 3 months after the onset. All patients underwent neck examination for the range of motion, and visual analog scale ( VAS ) was performed on some elder children. All patients received cervical spinal X ray, including PA lateral and open mouth position; some of the children also received an atlantoaxial spiral CT scanning and 3 D reconstruction. Three-dimensional CT examination focused on measuring atlantoaxial rotation angle in both vertical and sagittal axes of deformities. All patients underwent chiropractic manipulation. The treatment protocol included the children receiving continuous treatment for 2 to 3 days, 1 time / day, followed by 2 to 3 times /week, 2 weeks with a cervical collar. Each patient received spiral CT after the treatment for reviewing. VAS scores prior and post to the treatment were statistically analyzed.Results After the treatment, most children had signiifcant improvement in pain symptoms. Eleven patients received VAS evaluation before ( 7.2 - 10 points, mean 8.68 points ) and after the treatment ( 0 - 3 points, mean 1.75 points ), showing signiifcant improvement with statistical signiifcance (P < 0.01 ). Thirteen patients had imaging review and most of them improved significantly, but with different intervals ( 1.5 hours -7 years ). Only 2 cases showed slightly worsening in the review of X-ray, and further treatment and observation were needed.Conclusions Chiropractic manipulation is an effective way for young patients with atlantoaxial rotary subluxation; Spinal adjusting instrument is safer for patients with better compliance. Both of them can promote therapeutic efifcacy. Three-dimensional helical CT scan can show atlantoaxial in the vertical and sagittal axes of rotational angle of deformities with accuracy, guiding the treatment in clinic.
Keywords：Child pre ( 2-5 )Child ( 6-12 )Atlanto-axial jointDislocationsTomographyX-ray computedChiropractic
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 605-611 )