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Eric Chun-Pu Chu, BSc, DC, MHA, ICCSP, FRCC , Fa-Sain Lo, Amiya Bhaumik

Journal of Upper Cervical Chiropractic Research ~ October 7, 2020 ~ Pages 58-62



Dystonia is a neurological disorder characterized by sustained or intermittent muscle contractions resulting in twisting, repetitive movements or painful postures. Cervical dystonia (CD), an isolated dystonia of the cervical musculature, can predispose the atlantoaxial joint to unstable changes. Symptomatic treatment of dystonia through local injections of botulinum toxin clearly reduces pain in most clinical settings. However, repeated chemodenervation of the involved muscles with neurotoxin is expensive and not available to the complicated cases of CD. In this report a 14-year-old girl with a 1-year history of CD complicated by atlantoaxial subluxation was treated using chiropractic intervention. As a result of this regimen, the girl reported a significant relief from the neck pain and torticollis after the first week. More gains of cervical range of motion were made over the course of 6 months of treatment. Chiropractic might have yielded some biomechanical responses linked to clinical effects. This case demonstrates an unexpected association between CD and atlantoaxial subluxation. In cases of CDs, atlantoaxial subluxation may be ignored but requires specialized treatment. An index of suspicion should be maintained for this rare but potentially debilitating complication.

Key Words: Scoliosis, upper cervical, craniocervical junction, atlas, subluxation, adjustment, NUCCA, Grostic, Atlas Orthogonal, Advanced Orthogonal, Orthospinology

Copyright: This is an Open Access article distributed in accordance with the Creative Commons Attribution-Non Commercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See:

doi: 10.21037/acr.2020.03.03  Chu ECP, Lo FS, Bhaumik A. Secondary atlantoaxial subluxation in isolated cervical dystonia—a case report. AME Case Rep 2020;4:9.

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