Results of indirect vibropercussion correction of the first cervical vertebra position in chronic subluxation

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Abstract

BACKGROUND: Chronic subluxation of the first cervical vertebra (atlas) is a condition that remains insufficiently studied both in terms of diagnostic criteria and clinical outcomes of therapeutic interventions.

AIM: To evaluate the radiological and clinical outcomes of indirect instrumental correction of the C1 vertebra position using the Atlas-Standard protocol in patients with chronic pain syndrome.

Materials and METHODS: A single-center prospective study, AtlaStandard (ClinicalTrials.gov ID: NCT05986656), was conducted. Patients with chronic subluxation of the first cervical vertebra and lateral atlanto-dental interval asymmetry of ≥1 mm in at least one radiographic projection were consecutively enrolled. Indirect instrumental correction of the atlas position was performed using the Atlas-Standard technique with the ATLASPROF device. Follow-up radiography was scheduled one month after the intervention. Additionally, at six months, patients underwent a follow-up examination, physical assessment, survey, questionnaire-based evaluation, and spinal inclinometry.

RESULTS: The study included 46 participants — 14 men (30.4%) and 32 women (69.6%) — with a median age of 42 years (33; 49.8). After the intervention, a statistically significant reduction in lateral atlanto-dental interval asymmetry was observed in the anterior open-mouth projection and the posterior Fuchs projection, along with a decrease in the atlas tilt angle (p <٠.٠٥). Additionally, there was a significant reduction in the median tension headache intensity (measured by a numerical rating scale) and median pain levels across all spinal regions — cervical, thoracic, lumbar, and sacral (p <0.05). The use of analgesics decreased (p <0.001), functional disability scores on the Oswestry Disability Index 2.1a improved (p <0.05), and the vertical spinal axis deviation angle normalized in both the sagittal and frontal planes (p <0.05). No serious adverse events were recorded.

CONCLUSION: The Atlas-Standard technique using the ATLASPROF device enables indirect correction of the first cervical vertebra position in cases of chronic subluxation, as confirmed by radiographic data, with effects observed for at least one month post-procedure. Moreover, six months after treatment, this method demonstrates positive clinical outcomes, including reduced tension headache intensity, decreased pain in all spinal regions, reduced analgesic use, improved functional disability score, and normalization of spinal axis deviation angles.

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About the authors

Aleksandr S. Yanpolskiy

AXELANTA clinic; Alexandro-Mariinsky Regional Clinical Hospital

Email: 79171930619@ya.ru
ORCID iD: 0009-0000-7938-9589
SPIN-code: 7172-3264
Russian Federation, 2 Tatisheva st, Astrakhan, 414056; Astrakhan

Denis A. A. Borsuk

AXELANTA clinic; South Ural State Medical University

Email: borsuk-angio@mail.ru
ORCID iD: 0000-0003-1455-9916
SPIN-code: 3745-9539

MD, Dr. Sci. (Med.)

Russian Federation, 2 Tatisheva st, Astrakhan, 414056; Chelyabinsk

Maxim I. Galchenko

Saint Petersburg State Agrarian University; North-West Institute of Management — branch of the Russian Presidential Academy of National Economy and Public Administration

Email: maxim.galchenko@gmail.com
ORCID iD: 0000-0002-5476-6058
SPIN-code: 8858-2916

Senior Lecturer

Russian Federation, Saint Petersburg; Saint Petersburg

Marina Yu. Gerasimenko

Russian Medical Academy of Continuous Professional Education; N.I. Pirogov Russian National Research Medical University

Author for correspondence.
Email: mgerasimenko@list.ru
ORCID iD: 0000-0002-1741-7246
SPIN-code: 7625-6452

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow; Moscow

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Supplementary files

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2. Fig. 1. X-ray of the craniocervical region in anterior projection through an open mouth.

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3. Fig. 2. X-ray of the craniocervical region in posterior projection. Lines A and B are drawn to define LADI 2: A–B — right LADI 2; B–A — left LADI 2.

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4. Fig. 3. X-ray of the craniocervical region in 90⁰ lateral projection. Lines C and D are drawn to determine anterior atlanto-dental interval (a gap between the indicated lines).

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5. Fig. 4. STROBE diagram of the AtlaStandard study. LADI — lateral atlantodental interval.

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6. Fig. 5. Distribution of LADI 1 asymmetry (mm) and 95% CI of the median before and after the atlas position correction procedure.

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7. Fig. 6. Distribution of LADI 2 asymmetry (mm) and 95% CI of the median before and after the atlas position correction procedure.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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