Revista de la Facultad de Ciencias Médicas de Córdoba (Feb 2018)

Pseudoluxation C2-C3 in childhood

  • Marina Angulo Tabernero,
  • Enrique Suñén Sánchez,
  • Diego Peña Jiménez,
  • Antonio Loste Ramos,
  • Antonio Tabuenca Sánchez,
  • Alfredo Chárlez Marco,
  • Javier Rodríguez Vela

DOI
https://doi.org/10.31053/1853.0605.v74.n3.12863
Journal volume & issue
Vol. 74, no. 3
pp. 288 – 292

Abstract

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Cervical spine injury is rare in children. It is seen primarily in those who sustain significant, severe blunt trauma, occurring in 1 to 2 percent of such cases. The interpretation of cervical spine radiographs and the clinical examination in children may be difficult.The objective of this case clinic is to report on a physiological radiographic finding of the cervical spine in childhood that trends to be misjudged as pathologic: C2-C3 pseudosubluxation. We presented a boy, aged 5 years, who came to our Traumatic pediatric emergency center for cervical pain after falling from a height. In lateral radiographs we observed a disruption of the alignment of the anterior and posterior vertebral body line in C2-C3 space. A detailed anamnesis as well as a meticulous radiological and clinical exploration, allow to establish the right diagnosis in most cases, without any other complementary probe. Pseudosubluxation of C2 anterior to C3 is seen in approximately 40 percent of children under the age of 8 years. Pseudosubluxation can be differentiated from true subluxation by evaluating the spinolaminal line (Swischuk), line between the anterior aspects of the C1 and C3 spinous processes. The suitable radiographic interpretation of the cervical spine in children requires the knowledge of the peculiarities of this segment in the pediatric age.

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