Iatrogenic atlantoaxial rotatory subluxation after spinal manipulative therapy in a child

Abstract

Spinal manipulative therapy (SMT) is used for various therapeutic purposes in both the adult and pediatric population. Several adverse events arising from the use of SMT have been reported in the adult population but only few among children. We report a case of an 8-year-old female with atlantoaxial rotatory subluxation (AARS) secondary to aggressive cervical manipulation as a traditional cure for asthma. The patient presented with neck pain and torticollis with no other neurologic deficits. Computed tomography showed an atlantoaxial rotation of 47 degrees to the left without any osseous fractures. MRI was performed revealing intact discoligamentous complex. The patient was placed in a cervical orthosis for a total of 6 weeks and made full recovery with relief of pain and maintenance of neck full range of motion.