Atlantoaxial Subluxation: Symptoms & Treatment

Instructor: Dan Washmuth

Dan has taught college Nutrition, Anatomy, Physiology, and Sports Nutrition courses and has a master's degree in Dietetics & Nutrition.

Atlantoaxial subluxation is a condition where the vertebra in the neck become slightly dislocated or misaligned. In this lesson, learn about the symptoms and treatment for this type of injury.

Atlantoaxial Subluxation

Monica is a 43-year-old veterinarian who was driving home after a long day at work. As she was crossing a busy intersection, a car ran a red light and was heading straight towards her car. Luckily, Monica reacted quickly and steered away from the car, just missing a head on collision by a few feet. However, Monica drove right into a light pole at the corner of the intersection.

Monica checked her body for injuries and luckily she didn't seem to have any broken bones or major cuts. However, Monica's neck was in a lot of pain which she thought was probably from the whiplash she got as her car hit the pole.

An ambulance quickly arrived at the scene and the paramedics evaluated Monica. Monica told them about her neck pain and they immediately put a neck brace on her and then drove her to the hospital. At the hospital, doctors performed several tests on Monica's neck to see if there was any serious damage. After reviewing the results, one of the doctors told Monica that she had an atlantoaxial subluxation.

Atlantoaxial subluxation is a condition in which the C1 and C2 vertebrae in the neck become slightly dislocated or misaligned. The C1 and C2 vertebrae are the first two vertebrae at the top of the spine, located just below the skull.

Atlantoaxial subluxations can be caused by trauma from car accidents and sports collisions, as well as genetic disorders of the connective tissues of the body. Some of these genetic disorders, including Down syndrome and Marfan syndrome, can lead to weak and fragile bones that cause joints to be more prone to dislocations, including the atlantoaxial joint. Rheumatoid arthritis, a chronic inflammatory condition of the joints, is another common cause of atlantoaxial subluxations.

The C1 and C2 vertebrae are the top two vertebrae in the neck. These two vertebrae form the atlantoaxial joint.
cervical spine

Atlantoaxial Subluxation: Symptoms

One of the most common symptoms of atlantoaxial subluxation is pain in the neck, just below the skull where the C1 and C2 vertebrae are located.

Atlantoaxial subluxation can put pressure or stress on the spinal cord and spinal nerves in the neck, also known as the cervical nerves. Since the cervical nerves control the muscles in the upper extremities, pressure or stress being applied to these nerves caused by an atlantoaxial subluxation can cause various symptoms in the upper extremities, including:

  • Muscle weakness
  • Spasticity (a condition in which muscles are continually contracted)
  • Decreased dexterity

Atlantoaxial Subluxation: Treatment

Minor atlantoaxial subluxations that are relatively stable are usually treated conservatively. A brace will be placed on the neck to keep the neck immobilized. Immobilizing the neck can allow the atlantoaxial joint to rest and heal properly.

More severe atlantoaxial subluxations often require surgical repair. During surgery, the atlantoaxial joint will often be fused together by inserting metal screws, pins, and rods into the C1 and C2 vertebrae to permanently join them together.

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