The cervical pain syndrome in children and teenagers

Abstract

Purpose: to find the diagnostic methods for determining the etiology of the cervical pain syndrome; to elaborate the optimal treatment strategy. Materials and methods. The clinical experience is based on the results of examination and treatment of 587children 3-17 years old over the 15-year period. The acute pain was noticed at 138(23.5%) patients and the chronic one – at the 449(76.5%). Results: All the cases of the acute pain syndrome were caused by the acute subluxation in the atlanto-axial joint. In 111(80.4%) cases it appeared after a trauma and in 27(9.6%) – after inflammatory processes in the nasopharynx. The C1-C2 subluxation was also determined at 393(87.5%) children with the chronic pain syndrome. The pain at these patients was always accomplished with the symptoms of vertebro-basilar insufficiency and different neurological signs. At the another. At 112(81.0%) the acute pain syndrome was cured by the head-halter traction. At 26(19.0%) the one-time reposition of the C1-C2 subluxation was performed under the general anesthesia. In the cases of the chronic pain syndrome the optimal methodology turned to be the isometric relaxation with the following one-time reposition of the C1-C2 subluxation and the elimination of the intervertebral functional blocking. Conclusions: 1. The acute cervical pain syndrome was caused by the acute subluxation in the atlanto-axial joint. For its treatment the head-halter traction is indicated. If it is impossible, the one-time reposition under the general anesthesia with the following immobilization by the neck collar should be used; 2. The chronic cervical pain syndrome was caused by many different factors. In these cases the treatment should include the procedures of manual medicine which need to be determined in each particular case.