OBJECTIVE: To investigate the relationship between radiographic signs of subluxation in the cervical vertebrae and their clinical diagnostic value.

DESIGN: Controlled, clinical study.

SETTING: Institute of Clinical Anatomy and Biomechanics and NanFang Hospital of the First Military Medical University, Guangzhou, China.

SUBJECTS: Eighty-seven subjects with cervicodynia and 21 asymptomatic volunteers.

INTERVENTIONS: Radiological signs of subluxation from anteroposterior, lateral, open-mouth and dynamic radiographs of the cervical vertebrae of the subjects were measured and analyzed.

MAIN OUTCOME MEASURES: The right and left odontoid lateral mass interspace, divergence of the spinous processes, sign of double contour and position of odontoid process were studied.

RESULTS: The bilateral odontoid lateral mass interspaces were asymmetrical in most cases, and the divergence of spinous processes, sign of double contour and position of odontoid process were also common. Cervical vertebrae C5, C4 and C6 showed no special variations.

CONCLUSION: There was little evidence to support the contention that signs of subluxation in the cervical vertebrae are of diagnostic significance. Subluxation should be defined in two ways: as a purely roentgenological diagnosis and as a combination of roentgenological signs with clinical signs.

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