Department of Orthopedics, KKT Orthopedic Spine Center, Jeddah, Saudi Arabia.
Department of Physiotherapy, KKT Orthopedic Spine Center, Jeddah, Saudi Arabia.
Am J Case Rep. 2022 Jul 19;23:e936128. doi: 10.12659/AJCR.936128.
BACKGROUND There are several reports of atlantoaxial subluxation caused by upper respiratory tract infections. Although, there are many known non-pulmonary complications COVID-19 infection, to date there have been no reported cases of orthopedic complications in the peer-reviewed literature. Diagnosis and management of atlantoaxial subluxation is currently limited. Therefore, it is important to explore other methods of identifying and treating patients suffering from atlantoaxial subluxation. CASE REPORT Our patient was an 86-year-old man with right-sided neck pain and reduced range of neck motion for the past 6 months, shortly after a mild case of COVID-19. Autoimmune and inflammatory workup was unremarkable. Patient's symptoms persisted despite 3 weeks of conservative therapy with analgesics, cervical collar, and physical therapy. He received low-frequency kinetically directed impulse wave (al-Kindi wave) treatment administered by the KKT device after 3-dimensional digital X-ray analysis of the atlas. After receiving the treatment over a period of 13 days, patient showed significant improvement in symptoms and follow-up X-rays. CONCLUSIONS For patient's having neck stiffness or pain with COVID-19, it is important to consider atlantoaxial subluxation as a potential cause, especially if the patient requires intubation, as the technique should be adjusted to reduce spinal injury. Atlas X-ray analysis with Spinalytics provides very precise measurements of the atlas in relation to the skull and cervical spine, and improvement in angles were seen before and after treatment. The al-Kindi wave treatment was also effective in reducing the patient's symptoms and improving cervical X-ray results, but further studies are required for confirmation.
有几起因上呼吸道感染导致寰枢关节半脱位的报告。尽管 COVID-19 感染有许多已知的非肺部并发症，但迄今为止，同行评议文献中尚无骨科并发症的报道。寰枢关节半脱位的诊断和治疗目前受到限制。因此，探索识别和治疗寰枢关节半脱位患者的其他方法很重要。
我们的患者是一名 86 岁男性，在 COVID-19 轻度感染后 6 个月出现右侧颈部疼痛和颈部运动范围缩小。自身免疫和炎症检查无异常。尽管患者接受了 3 周的保守治疗，包括止痛药、颈托和物理治疗，但症状仍持续存在。在对寰椎进行三维数字 X 射线分析后，患者接受了 KKT 设备的低频动力定向脉冲波（al-Kindi 波）治疗。在接受了 13 天的治疗后，患者的症状和随访 X 射线有了明显改善。
对于 COVID-19 后出现颈部僵硬或疼痛的患者，重要的是要考虑寰枢关节半脱位作为潜在原因，特别是如果患者需要插管，因为应调整技术以减少脊柱损伤。Spinalytics 的寰椎 X 射线分析可提供寰椎与颅骨和颈椎相对关系的非常精确的测量值，治疗前后角度均有改善。al-Kindi 波治疗也有效减轻了患者的症状并改善了颈椎 X 射线结果，但需要进一步研究以确认。
