title: Upper cervical manipulation combined with mobilization for the treatment of atlantoaxial osteoarthritis: a report of 10 cases.
abstract: OBJECTIVE
  This study presents the outcomes of patients with idiopathic degenerative and posttraumatic atlantoaxial osteoarthritis who were treated with upper cervical manipulation in combination with mobilization device therapy.
  
  
  METHODS
  A retrospective case review of 10 patients who were diagnosed with either degenerative or posttraumatic atlantoaxial arthritis based on histories, clinical symptoms, physical examination, and radiographic presentations was conducted at a multidisciplinary integrated clinic that used both chiropractic and orthopedic services. All 10 patients selected for this series were treated with a combination of upper cervical manipulation and mechanical mobilization device therapy. Outcome measures were collected at baseline and at the end of the treatment period. Assessments were measured using patients' self-report of pain using a numeric pain scale (NPS), physical examination, and radiologic changes. Average premanipulative NPS was 8.6 (range, 7-10), which was improved to a mean NPS of 2.6 (range, 0-7) at posttreatment follow-up. Mean rotation of C1-C2 at the end of treatment was improved from 28° (±3.1) to 52° (±4.5). Restoration of joint space was observed in 6 patients. Overall clinical improvement was described as "good" or "excellent" in about 80% of patients. Clinical improvements in pain and range of motion were seen in 80% and 90% of patients, respectively.
  
  
  CONCLUSIONS
  Chiropractic management of atlantoaxial osteoarthritis yielded favorable outcomes for these 10 patients.
authors.affiliation: Department of Orthopedics, The 1st Affiliated Hospital of the General Military Hospital, Beijing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.forename: Shuxun
authors.initials: S
authors.lastname: Hou
authors.forename: Wenwen
authors.initials: W
authors.lastname: Wu
authors.forename: Xiaohua
authors.initials: X
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D002574:Cervical Vertebrae / Q000503:physiopathology; D006259:Craniocerebral Trauma / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal; D008875:Middle Aged; D019838:Neck Injuries / Q000150:complications / Q000000981:diagnostic imaging; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012399:Rotation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome