Biopharmaceuticals and medical sciences | Online ISSN 3064-9226
CASE STUDY   (Open Access)

Atlas Vertebral Realignment and Cerebrospinal Fluid Flow Restoration in Whiplash-Associated Disorder: A Case Report

Jonathan Verderame 1, Muhammad Shakib Arslan 2, Nishant Rangra 3

+ Author Affiliations

Journal of Precision Biosciences 6(1) 1-6 https://doi.org/10.25163/biosciences.619857

Submitted: 05 March 2024  Revised: 16 May 2024  Published: 19 May 2024 

Abstract

Background: Whiplash-associated disorder (WAD) results from sudden neck movements, often during vehicle collisions, leading to complex musculoskeletal and neurological symptoms. Diagnosing and treating WAD is challenging due to the variability in symptoms, which include neck pain, headaches, and dizziness. This study examines the role of atlas vertebral misalignment in WAD and highlights the effectiveness of atlas realignment as a treatment option. Methods: A 25-year-old male patient with WAD symptoms underwent atlas vertebral realignment using a non-invasive chiropractic technique. Pre- and post-treatment assessments included upright MRI to examine cervical spine alignment, cerebrospinal fluid (CSF) flow, and internal jugular vein compression. Treatment consisted of multiple atlas adjustment sessions over four weeks. Results: Pre-treatment imaging revealed atlas misalignment, ligamentous instability, loss of cervical lordosis, venous compression, and disrupted CSF flow. Post-treatment MRI demonstrated significant improvements in cervical alignment, venous decompression, and restored CSF flow. Clinically, the patient reported reduced headaches, improved cognitive clarity, and alleviated neck pain. Conclusion: Atlas vertebral realignment provided substantial symptom relief in a patient with WAD, correlating with improvements in structural and functional abnormalities. This case underscores the potential of targeted chiropractic interventions in managing complex WAD cases, particularly when imaging identifies atlas misalignment and CSF flow disruption. Further research is warranted to assess the broader applicability of this approach.

Keywords: Atlas vertebral realignment, Whiplash-associated disorder (WAD), Cerebrospinal fluid (CSF) flow, Upright MRI, Craniocervical junction (CCJ)

References

Blanpied, P. R., Gross, A. R., Elliott, J. M., Devaney, L. L., Clewley, D., Walton, D. M., ... & Torburn, L. (2017). Neck pain: revision 2017: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy, 47(7), A1-A83.

Bussieres, A. E., Stewart, G., Al-Zoubi, F., Decina, P., Descarreaux, M., Hayden, J., ... & Ornelas, J. (2016). The treatment of neck pain–associated disorders and whiplash-associated disorders: a clinical practice guideline. Journal of manipulative and physiological therapeutics, 39(8), 523-564.

Cassidy, J. D., Carroll, L. J., & Côté, P. (1998). The Saskatchewan health and back pain survey: the prevalence of low back pain and related disability in Saskatchewan adults. Spine, 23(17), 1860-1866.

Holm, L. W., Carroll, L. J., Cassidy, J. D., Hogg-Johnson, S., Côté, P., Guzman, J., ... & Haldeman, S. (2008). The burden and determinants of neck pain in whiplash-associated disorders after traffic collisions: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine, 33(4S), S52-S59.

Holmström, E. B., Lindell, J., & Moritz, U. (1992). Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Spine, 17(6), 672-677.

Ierano, J. J., & Richards, D. M. (2024). Atlas orthogonal chiropractic management of trigeminal neuralgia: A series of case reports. EXPLORE, 20(1), 70-78.

Jasper, L., & Smith, A. D. (2024). Social determinants of health in adults with whiplash-associated disorders. Scandinavian Journal of Pain, 24(1), 20230118.

Jull, G., Kenardy, J., Hendrikz, J., Cohen, M., & Sterling, M. (2013). Management of acute whiplash: a randomized controlled trial of multidisciplinary stratified treatments. PAIN®, 154(9), 1798-1806.

Mertens, K., & Vanhoenacker, F. M. (2023, October). Imaging of the Craniocervical Junction: A Pictorial Review. In Seminars in musculoskeletal radiology (Vol. 27, No. 05, pp. 499-511). Thieme Medical Publishers, Inc.

Peolsson, A., Nilsing Strid, E., & Peterson, G. (2024). Novel Internet Support for Neck-Specific Rehabilitation Improves Work-Related Outcomes to the Same Extent as Extensive Visits to a Physiotherapy Clinic in Individuals with Chronic Whiplash-Associated Disorders: A Prospective Randomised Study. Journal of occupational rehabilitation, 1-11.

Ragnarsdottir, H., Peterson, G., Gislason, M. K., Oddsdottir, G. L., & Peolsson, A. (2024). The effect of a neck-specific exercise program on cervical kinesthesia for patients with chronic whiplash-associated disorders: a case-control study. BMC Musculoskeletal Disorders, 25(1), 346.

Rabischong, P. (1989). Anatomie Functionelle du rachis et de la moelle. In Imagerie du rachis et de la moelle (pp. 109-134). Vigot Paris.

Riascos, R., Bonfante, E., Cotes, C., Guirguis, M., Hakimelahi, R., & West, C. (2015). Imaging of atlanto-occipital and atlantoaxial traumatic injuries: what the radiologist needs to know. Radiographics, 35(7), 2121-2134.

Shen, T. W. D. (2020). Investigation of Whiplash Associated Disorders using Finite Element Neck Models with Active Musculature in Frontal, Rear and Lateral Impact (Master's thesis, University of Waterloo).

Taverne, M., Lalieve, L., Persohn, S., Khonsari, R. H., Paternoster, G., James, S., ... & Laporte, S. (2024). Anatomy and mobility in the adult cadaveric craniocervical junction. Journal of Morphology, 285(7), e21748.

Vetti, N., Kråkenes, J., Eide, G. E., Rørvik, J., Gilhus, N. E., & Espeland, A. (2009). MRI of the alar and transverse ligaments in whiplash-associated disorders (WAD) grades 1–2: high-signal changes by age, gender, event and time since trauma. Neuroradiology, 51, 227-235.

Yigitkanli, K., Simsek, S., & Guzel, A. (2024). Posterior realignment of basilar invagination with facet joint distraction technique. British Journal of Neurosurgery, 38(1), 76-83.

PDF
Full Text
Export Citation

View Dimensions


View Plumx



View Altmetric



6
Save
0
Citation
207
View
2
Share