What are the symptoms of cervical dislocation in children?

Children's bones are relatively soft. If they are not careful, cervical dislocation may occur, which is quite harmful to children. There are many reasons for cervical dislocation in children. The most common one is that after a child has a cold, the throat becomes inflamed. At this time, the blood circulation will cause congestion and swelling of the cervical vertebrae, causing the ligaments and joint capsules to loosen, which sometimes leads to cervical dislocation.

What are the symptoms of cervical dislocation in children?

Cervical subluxation is mainly a mild displacement between the small joints between vertebrae, which is generally divided into anterior dislocation and lateral dislocation, with anterior dislocation being more common. The symptoms of anterior cervical subluxation are relatively mild, mainly manifested locally, such as easy fatigue of the neck, local pain, soreness, and fatigue; limited extension, flexion, and rotation of the head and neck;

The neck muscles are spasmodic, the head and neck are tilted forward, and the body feels stiff; the spinous processes and interspinous spaces of the injured segment are swollen and tender, and there may also be tenderness on the anterior side of the vertebra. Neurological symptoms are rare and usually mild.

Sometimes it manifests as symptoms and signs of nerve root irritation, but the real significance of cervical subluxation lies in its tendency to cause future instability and aggravate the degeneration of the intervertebral disc. If this instability between the vertebrae persists, according to Wolf's law, the vertebrae above and below the intervertebral disc will inevitably increase stability through bone hyperplasia and increase the contact surface between the vertebrae. Bone hyperplasia can cause the sagittal diameter of the spinal canal to shorten. In severe cases, it can compress the spinal cord and cause chronic spinal cord damage. Its clinical manifestations are similar to cervical spondylosis.

Disease diagnosis

Children often go to the hospital because they complain of sore throat. Examination shows congestion in the pharynx and swollen tonsils. This is often diagnosed as acute pharyngitis, and the patient is given anti-inflammatory and analgesic drugs. However, after a short while, the child's neck would suddenly tilt to one side, and he would not dare to move, with an expression of great pain. At this time, if an X-ray of the neck is taken, it can be confirmed that the child suffers from cervical subluxation. Cervical subluxation is a common disease in pediatric orthopedics, and the age of onset is mostly between 3 and 7 years old. There are 7 vertebrae in the human neck. The first cervical vertebra is called the atlas and the second cervical vertebra is called the axis. Atlantoaxial dislocation is the most common clinically. Its pathogenesis is generally believed to be that after inflammation of the neck, it can cause congestion of various tissues in the same nerve segment, leading to congestion of the ligaments around the atlas and axis, and bone absorption, loosening, and decalcification. Therefore, any minor trauma can cause subluxation between the axis.

The clinical manifestations are a history of acute inflammation of the throat and swollen lymph nodes in the neck more than three weeks before the onset of the disease, followed by a sudden disappearance of autonomous neck movement, the lower neck often tilting to one side, and occasional tenderness between the axes. A clear diagnosis can often be made by taking anteroposterior, lateral, and open-mouth X-rays of the cervical spine. The symptoms of this disease are very similar to pharyngitis, and it is often misdiagnosed and treatment is delayed in clinical practice, so it should be taken seriously.

After a child's atlantoaxial joint is dislocated, even minor head trauma such as rotation, sneezing, sudden braking while riding in a car can aggravate the dislocation, and may even cause suffocation and death due to traction on the vertebral artery or compression of the medulla oblongata. Therefore, once a child's cervical subluxation is diagnosed, parents must provide careful care and nursing, prohibit all strenuous activities, and go to the hospital for treatment as soon as possible. In mild cases, the head can be squeezed with a sandbag and the patient can rest in bed for 1-2 weeks. In severe cases, the head can be repositioned with a head sling. For those with acute inflammation of the throat, antibiotics and vitamin C can be given for treatment. Those without inflammation only need to use vitamin B1 and vitamin C. Generally, the patient can recover on his own after 1-2 weeks of treatment. If conservative treatment is ineffective, timely surgical treatment can be performed.