Atlas is the first cervical vertebra in mammals with a complete skeleton and spine. In humans, this department is a fundamentally important part of the musculoskeletal system. The neck is not just a part of the body with which we tilt or turn our head, it is the most mobile segment of the spine, through which the main blood vessels pass, transporting oxygen to the brain.
Building features
The cervical region consists of several vertebrae that are interconnected, but at the same time each of them remains mobile. The neck is credited with the highest motor activity throughout a person's life. Her vertebrae are small bodies with transverse processes, each of which received an opening for the passage of vital blood arteries and nerve endings.
The structure of the first cervical vertebra - the atlas attracts the most attention. Due to the presence of this element, the articulation with the skull remains mobile. By the way, he received the name "Atlant" in honor of the hero of ancient Greek mythology, holding on hisfirmament on his shoulders.
About how many cervical vertebrae a person has, each of us knows from the school anatomy course. There are seven of them, but the maximum load falls on the first. Throughout the day, when a person is awake, the head and cervical region are in constant dynamics. In this regard, some features of the anatomy of the first cervical vertebra (atlas) are distinguished:
- Unlike the other elements, it has no body.
- The side masses, which to some extent perform the function of the body, are two symmetrical structures. They are connected by the anterior and posterior arches of the atlas.
- The structure of the first cervical vertebra also implies the presence of two tubercles on the arches, front and back.
- The fossa of the tooth is a special depression on the back surface, which allows the atlas to connect with the odontoid process of the axis - the second vertebra of the neck. At the same time, both retain their mobility.
- A movable joint is placed between the atlas and the axis. Thanks to this cartilaginous element, a person can rotate his neck or make high-amplitude movements.
Subluxation and displacement
Atlas, the first vertebra of the human cervical region, has the smallest size. Outwardly, it is similar to a ring thickened on the side. The slightest damage in the articulation of the bones of the skull and neck can lead to serious consequences. For example, subluxation and dislocation are one of the most common injuries of this department, which are characterized by slippage of the odontoid process of the axis. In this case, the first cervical vertebra (atlas) is displaced. Howrepair such an injury?
In fact, it is not always possible to diagnose it in a timely manner. It is most dangerous when subluxation occurs in newborns. In addition, such damage may not manifest itself in any way for many years, and at an older age, when certain complaints appear against the background of the development of relevant pathologies, doctors, as a rule, do not associate this with the displacement of the atlas. The first cervical vertebra, or rather, anomalies in its structure or damage, can lead to various kinds of neurological symptoms.
So, you should understand the types of damage to the atlas. Its displacement is diagnosed in patients of various age groups. The main groups of pathologies are distinguished:
- congenital;
- post-traumatic;
- postoperative;
- degenerative;
- dysplastic.
Congenital changes in the structure of the atlas
Kimmerley's anomaly should be attributed to the first category - an additional bone arch is formed in the fetus over the vertebral artery in utero. Often, the formation is discovered by chance during an X-ray examination. Meanwhile, with Kimmerli anomaly, patients have an increased risk of squeezing blood vessels when tilting their heads, which, as a result, can lead to cerebrovascular accidents.
It is worth noting that this anomaly can be acquired. The most common cause of development is osteochondrosis - a degenerative process,flowing in the articular cartilage. In most cases, the treatment of this condition is conservative, trying to get rid of the problem with the help of the Shants collar and taking medications.
Post-traumatic disorders
Displacement of the atlas (the first cervical vertebra) is accompanied by the development of instability. In most cases, as already noted, the cause is birth trauma in babies. Intranatal ligament injury may be asymptomatic.
In adulthood, the displacement of the atlas will require a stronger mechanical effect. In the presence of strong ligaments, an injury to the first cervical vertebra can be provoked by:
- falling from a height or, for example, hitting your head on the bottom while diving in shallow places;
- traffic accident causing whiplash;
- a blow to the neck or head in a fight;
- sports training;
- incorrect headstand;
- wrong somersault;
- a sharp turn of the neck after sleep or prolonged rest.
Another reason for the displacement of the atlas can be a fracture of the spine. In this case, a big role is played not by how many cervical vertebrae in a person are damaged, but by whether the ligaments remain intact. The chances of restoring all functions of the cervical region depend on this. Meanwhile, even under the most favorable scenario, instability will remain in the spine for a long time.
Postoperative complications
After surgery, pathological changes at the level offirst cervical vertebra. The atlas is often displaced after a bilateral laminectomy.
It is important to note that operations on intervertebral hernias and protrusions at the level of the first two cervical vertebrae are performed in exceptional cases. Such interventions have a huge risk of complications due to the passage of the most important blood arteries and spinal structures.
Degenerative and dysplastic displacement
This pathology is quite rare, since the atlas does not have a fibrous intervertebral disc. Osteochondrosis most often affects the third and lower vertebrae.
With dysplastic syndrome, disorders occur throughout the spinal column, which is manifested by instability in all departments. With underdevelopment of the atlas or its individual structures, its fusion with the axis can be observed.
Symptoms of atlas displacement
This kind of complication is characterized by specific manifestations. When they occur and suspicion of displacement, it is necessary to conduct a comprehensive diagnosis. The results of the studies will allow you to accurately determine whether the correction of the first cervical vertebra is really needed. Atlas, changing its position, can provoke the appearance of such symptoms:
- pain in the neck and shoulder area, especially after heavy physical exertion;
- cramps;
- dizziness;
- half-fainting;
- head tiltone way;
- cephalgia;
- convulsions;
- sleep disorders;
- discomfort, tingling and burning of the neck muscles;
- slight soft tissue swelling;
- Hypertonicity of the upper back;
- acute torticollis (at an early age);
- uncertainty when turning the head, tilting.
Conservative Therapy
If the pathology has been confirmed in the diagnostic results, but the very moment of the shift is unknown, treatment should be started without delay. With a slight displacement of the first vertebra (up to 3 mm), conservative methods are used:
- physiotherapy exercises;
- Regular wearing of fixation collars;
- drugs that relieve inflammation and reduce muscle tone;
- pain blockade for severe pain syndrome;
- physiotherapy and massage.
If this treatment does not bring results after two or three months, the patient is advised to contact a neurosurgeon. The risks of complications and the feasibility of the operation are determined individually.
What to do immediately after an injury?
The tactics used in the treatment of displacement are practically independent of the age of the patient. If changes in the position of the atlas are detected immediately after the injury, three stages of therapy are carried out:
- First aid. The cervical region is immobilized with a splint or collar. It is important to achieve maximum immobility of the first cervical vertebrae and the atlas.
- Reposition. Thismanipulation should only be carried out by a specialist! Under no circumstances should you do this yourself! Injury to blood vessels or nerve endings passing there can lead to disability.
- Rehabilitation. For the recovery period, the patient may be prescribed wearing an orthosis, massage and gymnastics for the first cervical vertebra.
Treatment and rehabilitation in a medical facility
Atlant is being adjusted in a hospital setting. A traumatologist or a chiropractor, depending on the complexity of each particular case, can perform the procedure manually or with the help of a Glisson loop. The reduction of the atlas to babies is often carried out according to the Ruche-Guther method. In children, the vertebra often falls into place without any manipulation after the elimination of swelling and muscle spasm.
The rehabilitation period after reduction is of fundamental importance to exclude re-subluxation of the vertebra. In addition, it is extremely important to achieve maximum limitation of the load on the cervical region. It is worth constantly remembering that any sudden and careless movement will lead to a second displacement. Full recovery may take about six months. The chances of recovery are inversely proportional to the age of the patient: the older the person, the slower and more difficult tissue repair will be.
What are the risks and implications?
Subluxation, or displacement, of the atlas is a serious injury to the upper spine. You can't leave him unattended. By itself, without interferencedoctors, this condition will not pass. In children, untreated subluxation or displacement of the atlas is fraught with serious consequences, which may occur several years later. Specifically:
- decrease in visual acuity;
- delay in psychomotor development;
- development of scoliosis, osteochondrosis;
- torticollis;
- flat feet, clubfoot;
- high intracranial pressure;
- cerebral edema and frequent migraine attacks;
- chronic fatigue, fatigue;
- irritability;
- capriciousness;
- quick excitability;
- bad memory;
- hyperactivity and lack of concentration;
- convulsions;
- disorders of the digestive tract.
In most cases, the consequences of the trauma received at birth are significant changes in the well-being of the child in adolescence. Increased blood pressure, fatigue, headaches and weakness - all these manifestations are characteristic of a very common diagnosis of "vegetovascular dystonia". By the way, it is often caused by subluxation of the atlas.
