Nazheng stretch-rotation manipulation in the treatment of atlantoaxial subluxation in children: A case report.

RATIONALE: Atlantoaxial subluxation in children refers to a kind of disease characterized by neck deviation, pain, and limited activity as the main clinical manifestations resulting from dysfunction of the atlantoaxial joint due to trauma, poor posture, inflammation, or other etiological factors. In this paper, according to the special anatomical structure of the atlantoaxial joint, combined with the distinct physiological and pathological characteristics of pediatric development, the diagnostic criteria of atlantoaxial subluxation in children was supplemented, and a safer, painless, and easy-to-operate Nazheng stretch-rotation manipulation was proposed and applied to treat the disease, in order to provide new ideas and new methods for clinical diagnosis and treatment of atlantoaxial subluxation in children.

PATIENT CONCERNS: An 8-year-old Chinese girl was the patient. The patient presented with neck pain, cervical deviation, and restricted range of motion for over 2 months, accompanied by left flexion to right rotation, and the flexion and extension of the cervical spine, as well as the left and right rotation were clearly limited.

DIAGNOSES: Atlantoaxial subluxation.

INTERVENTIONS: Given the patient's condition, we used the Nazheng stretch-rotation manipulation as the primary therapeutic intervention, supplemented by traditional Chinese medicine hot compress.

OUTCOMES: After 4 days of treatment, a complete resolution of cervical pain was observed, with restoration of cervical shape, although flexion-extension and rotational movements remained mildly limited. After 11 days of treatment, the cervical range of motion had significantly improved, with near-complete restoration of flexion-extension and rotational mobility. After 20 days, both cervical morphology and functional mobility had returned to within normal physiological parameters.

LESSONS: Given the limited therapeutic options currently available for this disease, the clinical practice of this case confirmed that the reduction of atlantoaxial subluxation does not necessarily need to use the pulling method. As long as the periarticular soft tissues are fully released, the atlantoaxial joint can be reseted with minimal force during the stretching process. If this method can be replicated and promoted, it will further improve the safety parameters of manual treatment of atlantoaxial subluxation in children, and it will be more easily accepted by children and parents.