• Knutson GA

• Adult
• Injections, Spinal
• Leg Length Inequality
• Male
• Neck Pain

A 52-year-old male patient presented at this office complaining of severe headache, neck and shoulder pain, and dizziness or off-balance feeling. Examination revealed leg length inequality (LLI) and pelvic unleveling, indicating atlas subluxation/joint dysfunction. Although treatment was initially effective, extremely large mastoid processes made adjustment difficult and may have resulted in errant adjustment, joint irritation, and chronic atlas subluxation. After multiple conservative treatments, atlanto-occipital intra-articular joint injection was performed. Injection of the C0/C1, C1/C2 joints on the side of atlas laterality dramatically reduced LLI and pelvic unleveling. Photographs were taken in an attempt to document this effect. It is concluded that, at least in this one case, there was an atlanto-occipital, atlanto-axial intra-articular mechanism driving the neurological manifestations of LLI and pelvic torsion. Given the results, varying aspects of upper cervical practice are examined, including thediffering theories of atlas subluxation. Further study to document upper cervical subluxation/joint dysfunction and its neurologic sequellae using the atlanto-occipital intra-articular joint block technique is recommended.

Author Keywords: chiropractic, specific upper cervical, occipito­atlanto-axial subluxation.

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