A Case Report of Manipulation Under Anesthesia of Posttraumatic Type II Occipital-Atlantoaxial Rotatory Subluxation in a 4-Year-Old Girl

Morphological Characteristics of the Spinous Process of Axis: Clinical Implications for Cervical Spine Manipulation

“…1 In clinical spinal manipulation practice, the deviation of spinous process is regarded as very important objective evidence of minor misalignments of joints, such as the type I and II atlantoaxial rotatory subluxation and atlantoaxial rotatory fixations. 2 The diseases of the atlantoaxial joint have been a topic of general interest in clinical research owing to the high risk of myelopathy and life-threatening neurologic injuries. 3,4 Cervical spinal manipulation is one of the nonsurgical treatments to treat the diseases of minor misalignments of joints by manual therapists, chiropractors, physical therapists, etc.…”

Variable Morphology of the Axis Vertebrae in 100 Specimens: Implications for Clinical Palpation and Diagnostic Imaging

“…Plain film radiographs (including open-mouth views, posterior-anterior views, and lateral views) are usually suggested as a tool for evaluating the neck when atlantoaxial rotatory subluxation is considered. 2 Karhu et al 3 also recommended the use of conventional radiographs first in diagnosing AAS. Several reports state that odontoid-lateral mass asymmetry or lateralatlantodental space asymmetry and lateralized odontoid are considered as radiological criteria for the diagnosis of AAS [4][5][6][7][8][9] in open-mouth anteroposterior radiographs.…”

“…2,[19][20][21] Some authors suggest that when the spinous process of the axis palpated in the neck and it feels like it is pointing away from the midline toward the affected side (Sudeck sign, spine of the axis points in the direction of head tilt), it is also a clinical finding in AAS. [22][23][24][25] In addition, some reports state that deflection of spinous processes and/or transverse processes of the axis during palpation was used to determine the orientation and degree of AAS and provide useful information to cervical rotatory replacement manipulation treatment.…”