Clinical Pain

Korean Association of Pain Medicine (대한임상통증학회)
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Torticollis and Atlantoaxial Rotatory Subluxation after Chiropractic Therapy

카이로프랙틱 후 발생한 환축추 아탈구 및 후천성 사경

  • Kim, Doyoung (Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine) ;
  • Yun, Wang Hyeon (Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine) ;
  • Park, Jinyoung (Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine) ;
  • Park, Jung Hyun (Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine)
  • 김도영 (연세대학교 의과대학 재활의학교실 및 희귀난치성 신경근육병 재활연구소) ;
  • 윤왕현 (연세대학교 의과대학 재활의학교실 및 희귀난치성 신경근육병 재활연구소) ;
  • 박진영 (연세대학교 의과대학 재활의학교실 및 희귀난치성 신경근육병 재활연구소) ;
  • 박중현 (연세대학교 의과대학 재활의학교실 및 희귀난치성 신경근육병 재활연구소)
  • Received : 2018.11.18
  • Accepted : 2019.06.13
  • Published : 2019.12.31
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Abstract

Torticollis is an abnormal, asymmetric head or neck position which usually caused by imbalance of paracervical muscles. The traumatic torticollis can be caused by following events; atlantoaxial rotatory subluxation, atlantoaxial dislocation, cervical vertebral fractures, and injury to the cervical musculature. Especially, acute traumatic atlantoaxial rotatory subluxation usually presents limitation of cervical range of motion without pain or neurologic deficit. We report a case of a 58 year-old man who developed the acute atlantoaxial rotatory subluxation right after the chiropractic therapy, which induced the limitation of cervical range of motion to 52.5% of normal range. The magnetic resonance image revealed the facture of the odontoid process and the partial injury in transverse ligaments of the atlas. He underwent intramuscular botulinum toxin injection and 10 days of continuous cervical traction 15 hours a day using a 5 kg weight. The range of the cervical motion restored up to 90.2% of normal range.

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