The Posterior Approach in the Treatment of Lower Cervical Spine Subluxations
Traumatic disruption of the posterior ligaments of the cervical spine, generally caused by hyperflexion of the neck, whether associated or not with hyperextension — the whiplash injury —, may result in vertebral instability. This condition is not always recognized when injured patients are seen in the emergency room. X-ray examination of the cervical spine usually discloses minor abnormalities that are easily overlooked. However, the appearance of the spine may be normal even to the experienced eye. Some radiological findings have been suggested to represent clues to impending vertebral instability due to posterior ligament lesions : a) widening of the articular surfaces; b) increase of the interspinous distance; c) initial kyphotic appearance with a hinge at the lesion level; and d) reduction of the intervertebral disc space. Dynamic studies may confirm the diagnosis, showing an abnormal mobility of the vertebral bodies with loss of the normal articular relationships. If this condition is not recognized, the continuous movements of the neck lead to anterior subluxation, sometimes weeks or months after the injury [2, 3].
KeywordsCervical Spine Posterior Approach Whiplash Injury Minor Abnormality Intervertebral Disc Space
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