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Subluxation of the Cervical Spine

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Abstract

SUBLUXATION of the apophyseal articulations of the cervical spine and narrowing of the intervertebral space may follow an injury to an intervertebral cartilage. This abnormal position of the apophyseal articulations is the result of instability in the involved region of the cervical spine.

Hadley1 has pointed out that apophyseal subluxation in the lumbar region is capable of producing pain in three ways: (1) tension upon the capsular ligaments, (2) encroachment upon the size of the lumen of the intervertebral foramina, and (3) impingement of the ends of the articular processes against the pedicle above and the lamina below, respectively.

Encroachment upon the size of the lumen of the intervertebral foramen is likewise encountered in lower cervical subluxations since the anteroposterior diameter of the intervertebral foramen is smallest at points of maximum lordosis of the spine, namely the lower cervical and lower lumbar regions.

Semmes and Murphy2 state that narrowing of the intervertebral disk can allow narrowing of the intervertebral foramina only in the vertical diameter; such narrowing is not sufficient to cause pressure on the nerve root unless the intervertebral space is completely obliterated and there is destruction of the adjacent surfaces of the vertebrae. In some cases, however, we believe that subluxation of the apophyseal joints develops and the narrowing of the intervertebral foramen is manifested in the anteroposterior diameter as well as in the vertical diameter. This abnormal alignment of the neck can be visualized readily in the lateral roentgenograms of the cervical spine. Definite forward migration of. . .


 

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