We need you! See something you could improve? Make an edit and help improve WikSM for everyone.
Pseudosubluxation
From WikiSM
Contents
Other Names
- Physiologic anterior spondylolisthesis
Background
- This page describes 'pseudosubluxation', a physiological or normal anterior spondylolisthesis of the cervical spine seen in young children
History
Epidemiology
- Approximately 20% of children admitted for polytrauma will demonstrate this finding[1]
- Typically seen in children under age 8
- C2 on C3 #1 seen in 25% of children, C3 on C4 #2 in 15% (need citation)
- Rarely seen in adults[2]
Pathophysiology
- In young children, the vertebral facets are nearly horizontal, which gives them more mobility
- They become more vertical with age
- Anterior spondylolisthesis typically of C2 on C3
Risk Factors
- Age <8
Differential Diagnosis
- Fractures
- Subluxations and Dislocations
- Neuropathic
- Muscle and Tendon
- Pediatric/ Congenital
- Other Etiologies
Clinical Features
- General: Physical Exam Neck
- History
- Typically discovered following trauma
- Physical Exam
- Special Tests
Evaluation
Radiographs
- Standard Cervical Spine Radiographs
- Lateral view: anterior displacement of C2 vertebral body relative to C3
- Flexion Extension Cervical Spine Radiographs
- Up to 46% of normal children under 8 have 3 mm of motion of C2 on C3, 14% of C3 on C4[3]
- Subluxation should exaggerated with flexion and reduce on extension
- Absence of soft tissue swelling
- Swischuk's line
- Drawn from spinolaminar point on C1 to C3, should be within 2 mm of anterior cortex
CT
- Similar findings to radiographs
- More helpful to exclude fractures or other osseous injuries
MRI
- Useful for evaluating soft tissue injuries
Classification
- N/A
Management
Prognosis
- Excellent
Nonoperative
- By definition, non surgical
Rehab and Return to Play
Rehabilitation
- Needs to be updated
Return to Play
- Needs to be updated
Complications
- Generally none
See Also
- Internal
- External
- Sports Medicine Review Neck Pain: https://www.sportsmedreview.com/by-joint/neck/
References
- ↑ Shaw M, Burnett H, Wilson A, Chan O. Pseudosubluxation of C2 on C3 in polytraumatized children – prevalence and significance. Clin Radiol. 1999;54(6):377–80.
- ↑ Curtin P, McElwain J. Assessment of the “nearly normal” cervical spine radiograph: C2–C3 pseudosubluxation in an adult with whiplash injury. Emerg Med J. 2005;22(12):907–8.
- ↑ Cattell HS, Filtzer DL (1965) Pseudosubluxation and other normal variations in the cervical spine in children. A study of one hundred and sixty children. J Bone Joint Surg Am 47:1295–1309
Created by:
John Kiel on 3 May 2020 22:40:39
Authors:
Last edited:
6 October 2022 23:17:11
Categories: