What are the symptoms of atlas subluxation?

Atlas subluxation belongs to the joint of the first and second cervical vertebrae, and they lose the normal kiss and relationship. Although this is a relatively rare disease, once symptoms appear, it will seriously endanger the patient's health and easily cause compression of the high cervical vertebrae. Therefore, patients are prone to paralysis. In severe cases, it may even cause respiratory failure, and the mortality and disability rates are relatively high.

What are the symptoms of atlas subluxation?

Most patients have a chronic onset of the disease, with intermittent symptoms that recur repeatedly and gradually worsen; some patients experience significant worsening of symptoms after minor trauma. Typical clinical symptoms include the following:

1. Symptoms of cervical radiculopathy

Neck pain, limited neck movement, stiffness, especially limited rotation of the head and neck, pain in the occipital area, etc.

2. Compression of the medullary junction causes symptoms of high cervical myelopathy

Such as weakness in the limbs, unsteady walking, clumsy hands, abnormal bowel movements, etc.; it also includes numbness, tingling, or even burning sensations in the trunk and limbs.

3. Respiratory dysfunction

It usually occurs in severe or advanced cases. Due to the compression of the medullary spinal cord junction, respiratory dysfunction is a gradually worsening process - in the early stage of atlantoaxial dislocation, respiratory function is normal; later it will manifest as labored breathing during physical labor; severe patients have labored breathing even at rest, or the number of calm breathing is >30 times, cough is weak, and sputum is labored; terminal patients experience respiratory failure and even death.

4. Other symptoms

In addition, if combined with basilar indentation, cerebellar tonsillar herniation or syringomyelia, affecting the medulla oblongata and brainstem, symptoms of lower cranial nerves such as dysphagia, dysarthria (slurred speech), blurred vision, dizziness, tinnitus, etc. may also occur.

Causes

The stability of the atlantoaxial joint mainly depends on the following structures: the anterior arch of the atlas, the transverse ligament and the odontoid process of the axis; and the lateral mass joints between the atlas and the axis. If the integrity of the above structures is destroyed or they are misused for some reason, it may cause instability or dislocation of the atlantoaxial joint. There are many causes of the disease, such as old odontoid fractures caused by trauma, congenital malformations of the odontoid, infection or inflammation that damages the transverse ligament or lateral mass joint, and even tuberculosis or tumors invading the atlantoaxial joint, all of which can cause atlantoaxial instability or dislocation. The most common clinical causes are trauma and congenital malformations.

In the early pathological state, the atlantoaxial joint loses its normal apposition, but in certain positions (such as when the neck is extended), the atlantoaxial joint can still be repositioned. This situation should be called instability. The patient has a long medical history and the atlantoaxial joint cannot be repositioned no matter how the body position is changed. This condition is called atlantoaxial dislocation.