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  • Anterior displacement of C2 on C2 and/or
  • Angulation at this level (1)

Clinical Presentation

  • Children up to age 10.
  • On lateral C- spine after trauma.
  • Up to age 10: flex/ ex are centered at C2-3 moves down to C4-5 or C5-6 after age 10. (2)
  • C2 normally moves forward on C3 to 2-3 mm in peds. (2)
  • Head is flexed, displacement expected- exacerbated by spasm. (1, 2)
  • Pain not uncommon. (3 )
  • Pseuosubluxation corrected when head was in true neutral position.


  • Treat patient for soft- tissue injury and not subluxation.

1. Bailey DK. The normal cervical spine in infants and children. Radiology. 1952;59:712-719

2. Townsend EH, Jr., Rowe ML. Mobility of the upper cervical spine in health and disease. Pediatrics. 1952;10:567-574

3. Jacobson G, Bleeker HH. Pseudosubluxation of the axis in children. Am J Roentgenol. 1959:472-481


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