Man Ther. 1996 Jun; 1(3): 127-132.

Pathogenesis of upper cervical instability.

Swinkels R, Beeton K, Alltree J.

Faculty of Experimental Anatomy and Manual Therapy, Free University of Brussels, Brussels, Belgium

SUMMARY. The purpose of this article is to review the pathogenesis of upper cervical instability. Instability can arise from inflammatory, congenital and traumatic causes. The commonest causes of atlanto-axial dislocation are rheumatoid arthritis and Down's syndrome. The review revealed much less information about the relatively minor instabilities that are probably responsible for a number of chronic complaints of the type seen by manual therapists. The potential involvement of passive (ligamentous), active (musculotendinous) and neural control subsystems in maintaining the stability of the spine may go some way to explaining the spectrum of conditions included under the term clinical instability. Copyright 1996 Harcourt Publishers Ltd.