Constant headaches can be associated not only with the manifestation of osteochondrosis, but also with subluxation of the vertebrae. C1 rotational subluxation is the displacement of the articular surfaces of the upper vertebra relative to the lower. This vertebra is prone to fractures, but its subluxation is more often diagnosed.
A bit of anatomy
The first cervical vertebra has a rather specific structure and differs from others. This is a ring with lateral masses that are adjacent to the base of the skull. The lower part of the vertebra is attached to the second cervical vertebra. The second vertebra has a tooth - the body of the first vertebra. Atlas is attached to this tooth using ligaments. This is called the Crewellier joint.
A wide range of movements is due to numerous ligaments, and this feature is the reason that a rotational subluxation of C1 occurs. The cervical spine is the most unprotected. Most often, subluxation of the cervical vertebra is diagnosed in newborn children, as a result of which they later develop osteochondrosis.
The difference between a subluxation and a dislocation
Subluxation is a violation of the natural relationship between the surfaces of the joint, while contact between the articulated surfaces is maintained. A dislocation is a complete loss of contact of the articular surfaces, but the integrity of the bones is not broken.
Classification
Depending on how much the articulating surface has shifted, a subluxation of ½, 1/3, is distinguished. With an almost complete displacement of the vertebrae, but the preserved contact, the subluxation is called horse subluxation.
Also subluxation of the cervical vertebra can be:
- rotational;
- active - vertebrae C1 and C2 diverge;
- according to Crewellier - blood vessels and spinal nerves are pinched;
- according to Kinbek - axial subluxation, in which there is a subluxation of both the vertebra and the atlas.
C1 rotational subluxation and active subluxation are in most cases diagnosed in infants. In adults, other types of pathology are more often observed.
Etiology of the phenomenon
C1 rotational subluxation can occur for various reasons. The most common ones are:
- Movement of the neck is too active during sports or when doing everyday household chores.
- Careless diving into the water.
- Falls and other accidents.
- Sleep on my stomach.
- Strong load on the spine.
Rotational subluxation of C1 vertebra in children is possible:
- In the presence of a congenital anatomical pathology.
- As a result of imperfection of the ligamentous apparatus.
- With birth injury.
- With pathology of the passage of the baby’s head - deviation from the central axis of the child’s body.
Clinical picture
The signs of C1 rotational subluxation are the most diverse. The clinical picture directly depends on the degree of displacement of the articular surfaces, as well as on their location. In newborns in the first months of life, pathology is not accompanied by symptoms, and signs of subluxation appear later - when a load is placed on the spine. If treatment measures are not carried out in a timely manner, the condition of the child will worsen, which will be manifested by headaches, moodiness, poor memory, increased fatigue and impaired gait.
In adults, the following are specific signs of subluxation of the cervical vertebra:
- acute pain in the cervical spine;
- noise in ears;
- dizziness;
- decrease in muscle strength in the limbs;
- cramps of the upper limbs;
- increased muscle tone in the neck;
- sleep pathology;
- pain in the back and jaw.
A patient with a subluxation suffers very much from the fact that he cannot lead a normal lifestyle - he has to be significantly adjusted.
The rotational subluxation of C1 also has nonspecific manifestations. This is swelling (mild) in the area of damage, pain in the neck during palpation. Also, when probing the neck, you can find a segment that has shifted from its natural position. In some cases, a different length of the legs is a non-specific symptom. The patient can hardly turn his neck to the side of the lesion, and his head is constantly in a stably wrong position.
Diagnostic measures
Methods of modern diagnostics make it possible to quickly determine the presence of subluxation of the cervical vertebra, and to begin the correct treatment of pathology. The most commonly used methods are:
- Consulting a neurologist who can provide the necessary information about the injury,
- Radiography, during which standard (lateral and straight) is used, as well as additional projections. For example, shots through the mouth, slanting shots, shots at the time of neck flexion and extension,
- CT and MRI. During these diagnostic procedures, a decrease in the height of the disk, displacement of the articular surfaces, asymmetry between the tooth and the atlas are revealed. It also reveals the condition of the soft tissues,
- If a long-standing rotational subluxation of C1 is suspected, rheoencephalography is prescribed , since in this case a deterioration in the blood supply to the brain is observed.
Based on the results, the neurologist makes a diagnosis and prescribes therapy. It is very important to diagnose on time before various complications begin.
Subluxation in a child
As already mentioned, such injuries are not uncommon in children. This is primarily due to the imperfection of the cervical ligaments and tendons, as well as the excessive ability of muscle tissue to stretch even with minor loads.
Rotational subluxation is the most common variant of subluxation of the cervical spine, which can occur with sudden turns of the head. In this case, the child has a forced inclined position of the head.
Active subluxation is observed with a strong muscle tone, is most often eliminated spontaneously and does not lead to negative consequences.
Kinbek subluxation is observed with damage to the C2 vertebra. This is a rare pathology, but requiring special attention, since it can very seriously affect the health of the child.
In some cases, subluxations are not diagnosed immediately after the child is injured. This is due to the lack of pronounced symptoms.
What is the danger?
The greatest danger of subluxations is that, due to the displacement of the vertebrae, the vessels are pinched, and this leads to ischemic brain regions. If the venous outflow is blocked, an increase in intracranial pressure is possible, which can provoke cerebral edema.
Another danger is that in the area of vertebral displacement, the spinal cord passes, which is responsible not only for the motor function of the limbs, but also for the work of internal organs. In addition, in this department there is a center that is responsible for breathing. When pinching the displaced vertebra of the spinal cord, blood circulation worsens.
Also, the consequences of cervical vertebra displacement include:
- numbness of the limbs;
- weakness in the arms and legs;
- deterioration of the sensitivity of the fingers;
- headache;
- trouble sleeping.
Violation of the functionality of the intestines, bladder, kidneys, paralysis, breathing problems - these are serious reasons for going to the doctor. You should not expect that the rotational subluxation will pass without medical assistance.
As for children, everything is more complicated. Until the child is one year old, the subluxation does not make itself felt, but then, when the baby begins to walk, he has an incorrect gait. Parents turn to an orthopedist who diagnoses flat feet or scoliosis, as a result, the pathology remains untreated and subsequently leads to a deterioration in the condition of the child.
First aid
Subluxation should be performed by a specialist who has special skills. It is forbidden to independently adjust the rotational subluxation, as this can lead to serious complications, including death.
As for first aid for subluxation of the cervical vertebra, it consists in ensuring the immobility of the damaged joint. To do this, you can use any means at hand. Next, you need to transport the victim to the hospital, or call an ambulance.
Treatment principles
An experienced specialist returns the vertebrae to their natural position. This is carried out manually according to the principle of leverage. Also, traction using the Glisson loop is considered quite effective . The device includes a set of belts and fasteners that are attached to the patient’s neck. In this case, the person is in a suspended state.
If a running subluxation has caused the neck muscles to overstrain and infringe on the joint capsule, treatment of C1 rotational subluxation should be started with the relief of muscle tension.
The Vitiugov method is also effective. The specialist performs local anesthesia, as a result of which the pain syndrome is stopped, and muscle tension is relieved. Thus, an independent reduction of the vertebra is possible. If the position of the displaced element is not restored, it is manually adjusted.
As for medicines, anti-inflammatory and painkillers are prescribed. A good effect is given by novocaine blockade with Diprospan. To remove muscle tone, it is recommended "Midokalm", which is a muscle relaxant of central action. Nootropic drugs that stimulate blood circulation are also prescribed. To improve the functioning of the nervous system, agents are prescribed that contain vitamin B, for example, Milgamma and Neurorubin.
Recovery
After the vertebra returns to its normal position, a number of measures are necessary to restore and stabilize the damaged neck. For this, wearing a Shants collar for up to two months is shown. Such a measure will make it possible to remove the load from the cervical vertebrae, and also limit the movement of the neck, which is important to prevent repeated subluxations, since the ligamentous apparatus weakens after receiving an injury. After the end of the acute period, massage, physiotherapy, acupuncture, exercise therapy are indicated. These procedures will allow to establish blood circulation, eliminate swelling, stop pain, and also significantly reduce the rehabilitation period.
What is a trench collar? What is the price of this fixture? How to use it? Shantsa collar is a very effective remedial remedy, which is prescribed to patients of all ages. The main purpose of this device is to reduce the load on the cervical spine, providing heat and light massage to the damaged area. The Shants collar has as many varieties as are generally distinguished by the material of manufacture (stiffness). As for the design, the product has no significant differences.
To choose the right Shants collar for an adult or a child, the help of an orthopedist is needed. An incorrectly selected product can lead to a deterioration in the patient's condition. Only a specialist can choose the correct size of the device, while not only the individual characteristics of the patient are taken into account, but also the clinical picture of the pathology. The neck retainer should fit the neck tightly, but not press on soft tissue. It is necessary to wear the collar of Shants daily, in some cases it is recommended not to take it off even at night. A specialist should tell about all the nuances of wearing. As for the price of the collar of Shants, it varies from 200 to 900 rubles.