Isabel Snee,Catherine  A. Mazzola,
C1-C2 Subluxation after Mild Cervical Spine Trauma in a Child
Surgical Case Reports
2020
2613-5965
http://dx.doi.org/10.31487/j.SCR.2020.07.17
https://www.sciencerepository.org/c1-c2-subluxation-after-mild-cervical-spine-trauma-in-a-child_SCR-2020-7-117 
Abstract: We report a case of a seven-year-old girl who presented with a “Cock-Robin” head tilt and cervical spine
injury after falling from her bed. Initial cervical spine X-ray reported a fractured clavicle. However, almost
four weeks later, the torticollis had not resolved. Computerized tomography (CT) of the cervical spine
revealed subluxation of the atlanto-axial joint at C1-C2. Cervical spine magnetic resonance imaging (MRI)
did not show any spinal cord injury. Manual reduction and hard collar placement were attempted, yet C1-
C2 subluxation recurred. The child was placed into halo traction and then into a halo vest. CT scan showed
near complete resolution of C1-C2 subluxation. Three months later the halo device was removed, and the
patient was placed in a hard cervical collar then transitioned into a soft collar over a four month period.
During this time, the patient received physical therapy. Final cervical spine radiographs revealed proper
cervical spine alignment and resolution of C1-C2 subluxation.Keywords: Atlanto-axial subluxation, cervical subluxation, cervical trauma, C1-C2 subluxation, subluxation