Pathophysiological Mechanisms and Clinical Implications of Upper Cervical Vertebral Subluxations (Neurological Disorders with Craniocervical Dysfunction)

Jonathan Verderame ¹ , M. Shakib Arslan ^2*

This review discusses upper cervical vertebral subluxations' neurobiological mechanisms, enhancing diagnosis and treatment in chiropractic care.

Abstract

Background: The craniocervical junction is a critical neuro-anatomical region, playing a significant role in health and disease due to its vulnerability. Upper cervical vertebral subluxations, defined as alterations in the atlanto-axial motion and/or position relative to the cranium and cervical spine, can disrupt normal physiological processes. This article aims to provide a comprehensive overview of the fundamental science, clinical models, and pathophysiology related to upper cervical vertebral subluxation. Methods: This review article synthesizes existing literature on upper cervical vertebral subluxation. It examines various models and mechanisms, including subluxation degeneration, the subluxation complex model, compression of the brainstem and neural structures, dysafferentation, the neurodystrophic model, and segmental facilitation. Neurobiological mechanisms such as dyskinesia, dysgenesis, dysautonomia, dysafferentation, neuroplasticity, and ephaptic transmission are also explored. Results: The review identifies and interprets multiple neurobiological mechanisms associated with upper cervical vertebral subluxations. Each model and mechanism highlights the potential impact on neurophysiology and overall health. The article discusses how these subluxations can lead to various systemic consequences, providing evidence from both fundamental science and clinical perspectives. Conclusion: Upper cervical vertebral subluxations have significant implications for health due to their potential to interfere with normal physiology through various neurobiological mechanisms. Understanding these mechanisms and their clinical relevance can enhance diagnostic and therapeutic approaches, ultimately improving patient outcomes. Further research is needed to deepen our understanding of these complex interactions and their broader implications for health and disease.

Keywords: Craniocervical junction, Vertebral subluxation, Neurobiological mechanisms, Chiropractic care, Cervical spine alignment, Atlanta axial joint, segmental dysfunction

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