What to do if your child has cervical subluxation

The cervical spine is very important to us and we cannot treat it carelessly. When people have cervical spine functional diseases, their first reaction is that the disease is not serious. In fact, if it happens to children, it will make parents very anxious, especially in the case of cervical subluxation, which must be treated strictly.

Cervical subluxation mostly occurs in adults and is rare in children.

It is an unstable injury of the cervical spine. What are the treatments for cervical subluxation? With this question, let's take a look at the introduction made by Professor Li Weixin of Tangdu Hospital of the Fourth Military Medical University:

What are the treatments for cervical subluxation? Traction can usually reduce the position, but skull traction is not necessary; occipital-mandibular belt traction is sufficient for reduction. During traction, the head is placed in the median position and the weight is 2 to 3 kg. After the reduction is confirmed by X-ray, traction is continued for 3 weeks. Because there is a tendency for severe instability after reduction and dislocation is very likely to recur, the head, neck and chest should be fixed with plaster for 2 to 3 months after reduction. After the plaster is removed, a neck brace is used to maintain the condition for a period of time. Manual reduction is not advisable. If it must be done, it should be done with caution to avoid further injury.

Surgery is not recommended in the acute phase. If instability of the injured segment still exists in the later stage or is accompanied by delayed spinal cord or nerve root compression, surgical treatment should be performed. The anterior cervical approach was used for disc removal, decompression and bone graft fusion. If there is spinal cord compression, extended decompression and bone grafting should be performed.

When the cervical spine is subjected to flexion violence, or when the cervical spine in the flexed position is subjected to longitudinal compression force, the anterior compressive stress of the affected vertebral body increases, while the posterior structure of the cervical spine is subjected to tensile stress. During the flexion movement of the vertebral body, the instantaneous rotation center of the adjacent vertebral body is located slightly posterior to the center of the intervertebral disc. At this time, the front part of the vertebral body is the fulcrum, and the tensile stress side is the joint capsule, interspinous ligament, yellow ligament, etc.

The continuous action of bending force and compressive force can produce two situations: if the compression force is large, it may cause the collapse of the anterior vertebral body, and sometimes may cause the posterior disc protrusion of the cervical disc; if the force does not cause vertebral fracture, the joint capsule and ligament on the tensile stress side may be torn, and in severe cases, the posterior longitudinal ligament may also be damaged.

The continued action of external force causes the two joints of the upper cervical vertebra to slide forward and separate and displace. This anterior sliding of the posterior facet articular process is related to the pathological basis of the intervertebral disc. If the intervertebral disc functions well during the stress process, the instantaneous center of rotation remains unchanged, and the external force exerted on the posterior joint is mainly tensile force. Dislocation is only possible when the joint capsule is torn. When the intervertebral disc degenerates, its height decreases, the annulus fibrosus and ligaments around the intervertebral disc relax, and there are potential instability factors in the intervertebral segments, during the violent process, the vertebral bodies are displaced or the center of rotation moves backward or downward instantaneously. The bending movement of the cervical spine generates huge shear force between the posterior facet joints, causing them to slide against each other, leading to ligament tearing and facet joint capsule tearing. Damage to the posterior longitudinal ligament is also one of the reasons for impaired intervertebral disc function.