Torticollis

New spinal cord research study findings recently were reported by J.E. Monckeberg and co-researchers

Torticollis Library Library Home This article was published in Pain & Central Nervous System Week, which you can subscribe to online.

"The term subluxation should be used only when C1-C2 is rotated beyond normal limits. Concepts about rotatory fixation were established by accepting that it may occur within the limits of normal range of motion. Although nowadays CT is the current image method used to evaluate any case of torticollis, no study has been performed in adult population on what really normal rotation look like in CT scans. The study included the measurement of the rotational movement of the neck and a CT scan study of the articular processes of C1-C2 in maximal, left and right, active rotation. A superposition of 6 consecutive slices was carried out, obtaining a linear contour of the axial view of C1-C2. Rotation angle and contact surface loss were measured. The average neck rotation angle was 79 (range: 74 to 81). The superposition of the images taken in every rotational direction showed a wide contact loss between the correspondent C1-C2 articular surfaces (42.4%-85.7%; average: 70%). The report of these images, carried out by 3 independent radiologists, concluded that there was a rotatory subluxation in all these cases. Our results coincide with our previous published ones conducted in children, and lead us to conclude that a CT scan showing wide-but incomplete rotational facet displacement is not sufficient to define subluxation. We perceive that there is a risk of overdiagnosis and overtreatment (C1-C2 arthrodesis) when evaluating upper cervical spine rotational problems," wrote J.E. Monckeberg and colleagues.

The researchers concluded: "The concept of both rotatory fixation and subluxation should be revised, and quantifying the rotational angle and contact surface loss between C1-C2 can be very useful."

Monckeberg and colleagues published their study in Spine (CT Scan Study of Atlantoaxial Rotatory Mobility in Asymptomatic Adult Subjects A Basis for Better Understanding C1-C2 Rotatory Fixation and Subluxation. Spine, 2009;34(12):1292-1295).

For additional information, contact C.V. Tome, Pio 12 S-N, Navarra, Spain.

Publisher contact information for the journal Spine is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: Spain, Life Sciences, Torticollis, Spine, Spine Research.

This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2009, Pain & Central Nervous System Week via NewsRx.com.