Analysis of somatometric parameters of children with recurrent subluxations of C1–C2 vertebrae

Introduction. The problem of instability in the cervical spine in children has been repeatedly discussed in the medical literature and has become the subject of discussion. This is due to a significant increase in the number and recurrence of subluxations in the C1–C2 segment. An assumption is made about the relationship of this pathology with systemic connective tissue dysplasia, but evidence-based studies are required.

Aim. To make a statistical analysis of individual somatometric indicators in children with recurrent subluxations of the C1–C2 vertebrae and signs of connective tissue dysplasia.

Materials and methods. The analysis of measurements of selected body parameters in pre-pubertal children with acute and recurrent torticollis against the background of systemic connective tissue dysplasia was carried out. The data of 186 children aged 9–11 years in comparative groups for the period 2016–2021 were studied. Modern methods of statistics were used.

Results. Dependences were obtained confirming the hypothesis of the relationship between asthenic physique (high height, low weight and chest circumference) and recurrent dislocations in the C1–C2 segment

Conclusions. When comparing the average values for two independent samples made up of the indicators of the main group and the comparison group, the conclusion obtained during visual examination and somatometric examination of patients diagnosed with torticollis at admission to the hospital was confirmed: relapses are inherent in children with high growth, low weight, smaller chest circumference and smaller wrist circumference.

1. Kozlov O.O., Krasnoyarov G.A., Tsybanov A.S. Sindrom of acute torticollis children. Vestnik Buryatskogo Gosudarstvennogo Universiteta. 2015;(12):39–45. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=24333828.

2. Gencpinara P., Erkan M. Non-traumatic atlanto-axial rotatory subluxation: A rare cause of neck stiffness. Turk J Emerg Med. 2015;15(3):145–146. https://doi.org/10.1016/j.tjem.2015.11.011.

3. Lustrin E.S., Karakas S.P., Ortiz A.O., Cinnamon J., Castillo M., Vaheesan K. et al. Pediatric cervical spina: normal anatomy, variants, trauma. Radiographics. 2008;23(3):539–560. https://doi.org/10.1148/rg.233025121.

4. Maigne J.Y., Mutschler C., Doursounian L. Acute torticollis in an adolescent: case report and MRI study. Spine. 2003;28(1):13–15. https://doi.org/10.1097/00007632-200301010-00026.

5. Vetrile S.T., Kolesov S.V. Craniovertebral pathology. Moscow: Meditsina; 2007. 320 p. (In Russ.) Available at: https://search.rsl.ru/ru/record/01003089276.

6. Gubin A.V., Burtsev A.V., Ryabykh S.O., Savin D.M., Ochirova P.V., Korkin A.A. Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixation. Traumatology and Оrthopedics of Russia. 2015;4(78):87–94. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=25406785.

7. Yarikov A.V., Fraerman A.P., Perlmutter O.A., Simonov A.E., Smirnov I.I. Injury of the subaxial level of the cervical spine: clinical picture, diagnosis, treatment tactics. Health. Medical Ecology. Science. 2018;3(75):89–97. (In Russ.) https://doi.org/10.5281/zenodo.1488060.

8. Liev A.A., Skorobogach M.I., Tatyanchenko V.K. The role of rotational subluxation of the atlas in the developmen of myofascial pain syndrome and scoliotic spinal deformity. Hirurgia Pozvonochnika. 2008;(3):81–87. (In Russ.) https://doi.org/10.14531/ss2008.3.81-87.

9. Ulrich E.V., Gubin A.V. Signs of neck pathology in clinical syndromes: a manual for doctors. St Petersburg: Sintez Buk; 2011. 79 p. (In Russ.) Available at: https://www.researchgate.net/publication/276308508_Priznaki_patologii_sei_v_kliniceskih_sindromah_Cervical_Spine_in_Clinical_Syndromes.

10. Tabe E.E., Malakhov O.A., Chelpachenko O.B., Zherdev K.V., Taybulatov N.I., Vasil’chenko V.V. Optimal methods for diagnosis of cervical spine instability in children. Russian Pediatric Journal. 2013;(1):45–50. (In Russ.) Available at: https://elibrary.ru/item.asp?id=18818222.

11. Rumyantseva G.N., Vinogradov A.F., Rasskazov L.V., Krest’yashin V.M., Murga V.V., Ivanov Yu.N. et al. The role of connective tissue dysplasia in the formation of surgical pathology in childhood (Literature review). Upper Volga Medical Journal. 2019;18(3):27–32. (In Russ.) Available at: https://medjournal.tvergma.ru/423/1/07.pdf.

12. Demin V.F., Kliuchnikov S.O., Kliuchnikova M.A. The implication of connective tissue dysplasia in childhood pathology. Current Pediatrics. 2005;4(1):50–56. (In Russ.) Available at: https://elibrary.ru/item.asp?id=18023068.

13. Tyabut T.D., Karatysh O.M. Undifferentiated connective tissue dysplasia. Sovremennaya Revmatologiya. 2009;(2):19–22. (In Russ.) Available at: https://elibrary.ru/item.asp?id=13121695.

14. Kildiyarova R.R., Nechaeva G.I., Chernysheva T.E. Connective tissue dysplasia. Moscow: GEOTAR-media; 2020. 160 p. (In Russ.) https://doi.org/10.33029/9704-5325-4-DYS-2020-1-160.

15. Tvorogova T.M., Vorobyeva A.S. Undifferentiated connective tissue dysplasia from the position of dyselementosis in children and adolescents. RMJ. 2012;(24):1215. (In Russ.) Available at: https://www.rmj.ru/articles/pediatriya/Nedifferencirovannaya_displaziya_soedinitelynoy_tkani_s_pozicii_dizelementoza_u_detey_i_podrostkov.

16. Kalaeva G.Y., Khokhlova O.I., Deev I.A., Samoilova J.G. The incidence and clinical characteristics of connective tissue dysplasia in adolescents. Pediatric Pharmacology. 2017;14(5):373–379. (In Russ.) https://doi.org/10.15690/pf.v14i5.1785.

17. Kadurina T.I., Gorbunova V.N. Connective tissue dysplasia: a guide for doctors. St Petersburg: ЕLBI-SPb; 2009. 702 p. (In Russ.) Available at: https://search.rsl.ru/ru/record/01004334261.

18. Alekperov R.T. Mixed connective tissue disease, undifferentiated connective tissue disease and overlap syndromes. Almanac of Clinical Medicine. 2019;47(5): 435–444. (In Russ.) https://doi.org/10.18786/2072-0505-2019-47-022.

19. Lang T.A., Sesik M. How to report statistics in medicine. Philadelphia: American College of Physicians; 2006.

20. Junkerov V.I., Grigoriev S.G. Mathematical and statistical processing of medical research data. St Petersburg: Military Medical Academy named after S.M. Kirov; 2002. 267 p. (In Russ.) Available at: https://search.rsl.ru/ru/record/01001845946.