A surprising case of a cervical spine subluxation
Four articles on PainSci cite Moon 2008: 1. The Complete Guide to Low Back Pain 2. The Complete Guide to Neck Pain & Cricks 3. Does Spinal Manipulation Work? 4. Spinal Subluxation
PainSci notes on Moon 2008:
This paper describes the case of a man who developed severe neck and shoulder pain after a fall. It turned out that a part of one of his neck vertebrae was entirely missing, since birth (“a relatively uncommon developmental anomaly”). The fall subluxed the joint substantially. Although painful, the lack of neurological symptoms is surprising — and more evidence that nerve roots are not easily pinched.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
STUDY DESIGN: Case description.
OBJECTIVES: To describe a case of traumatic subluxation in association with a congenitally absent cervical pedicle, and review the pertinent medical literature.
SUMMARY OF BACKGROUND DATA: The congenital absence of a cervical pedicle is a relatively uncommon developmental anomaly that is frequently mistaken for a unilateral facet fracture-dislocation in the context of acute trauma. Because there is little evidence of recovery after surgery, and the symptoms are usually not disabling, surgery is not recommended for most cases.
METHODS: A 62-year-old man presented with severe neck and right shoulder pain after falling. Plain radiographs and computed tomography of the cervical spine showed the typical features of a congenitally absent pedicle at C6 with anterolisthesis of C6 on C7. We performed anterior interbody fusion at C6-C7 because of persistent neck pain and progressive instability.
RESULTS: Complete restoration of the C6-C7 subluxation was achieved with resolution of the presenting symptoms. At 18 months follow-up, flexion and extension dynamic radiographs demonstrated good alignment with solid fusion at C6-C7.
CONCLUSION: Although conservative treatment is the primary treatment for this clinical entity, surgery is an alternative option for those patients who fail to achieve recovery after conservative treatment or exhibit instability.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study. Kasch 2022 Spine (Phila Pa 1976).
- A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Yousef 2013 Anaesthesia.
- Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Richards 2021 Phys Ther.
- Sudden amnesia resulting in pain relief: the relationship between memory and pain. Choi 2007 Pain.
- Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Guimarães 2021 Pain.