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Chiropractic Journal of Australia : CJA March 2013
32 Chiropractic Journal of Australia Volume 43 Number 1 March 2013 dental procedures6 and is subsequently outside of their area of interest. Secondly imaging is often requested subsequent to head or neck injury and symptoms such as headache or neck pain may be regarded to be a direct result of the trauma. There is, however, in the scientifc literature a gap in knowledge and further research is needed to investigate if SBO of C1 causes an increased incidence of headaches and neck pain. The results of this study suggest that there is no association, however due to the relatively small sample size further investigation is warranted. Future investigations could be designed to be more sensitive, grading severity of HA and NP and identifying patients who presented to other healthcare professionals for treatment of their headache or neck pain. The retrospective nature of this study was also a limiting factor. All patients included in the study had undergone cervical radiography for clinical reasons. This would suggest that a higher incidence of HA and NP would be expected in both the experimental and control groups than would be indicated in the normal population. The incidence of neck pain has been reported to be between 15% and 50%,14,15 however, which is consistent with the values found in this research. Neck pain and headache individually showed different incidences between the two groups and statistical analysis of these two pain syndromes separately may have been more appropriate to assess for any clinical signifcance with respect to SBO of C1. A prospective study of a larger, random group of subjects would be ideal to assess more accurately the incidence of SBO, the incidence of NP and HA and how these may correlate with each other. REFERENCES 1. Weng C, Wang LM, Wang WD, Tan HY. Bipartite atlas with os odontoideum and synovial cyst: case report and review literature. Spine 2010;35(12):E568-75. 2. Chung, Sang-Bong; Yoon, Sang Hoon; Jin, Yong Jun; Kim, Ki-Jeong; Kim, Hyun-Jib. Anteroposterior spondyloschisis of atlas with incurv- ing of the posterior arch causing compressive myelopathy. Spine 2010;35(2):E67-E70. 3. Childers JC Jr, Wilson FC. Bipartite atlas. Review of the literature and report of a case. J Bone Joint Surg Am;1971:53(3):578-82. 4. Klimo P, Blumenthal DT, Couldwell WT. Congenital partial aplasia of the posterior arch of the atlas causing myelopathy: Case report and review of the literature. Spine 2003; Vol 8:E224-8. 5. Park, Jung-Soo; Eun, Jong-Pil; Lee, Hai-Ong. Anteroposterior spondy- loschisis of atlas with bilateral cleft defect of posterior arch: A case report. Spine. 36(2):E144-E147, January 15, 2011. 6. Popat H, Drage N, Durning P. Mid-line clefts of the cervical vertebrae - an incidental fnding arising from cone beam computed tomography of the dental patient. Br Dent J 2008 Mar 22;204(6):303-6. 7. Prempeh RC, Gibson JC, Bhattacharya JJ. Mid-line clefts of the atlas: a diagnostic dilemma. Spinal Cord 2002;40(2):92-3. 8. Adam A, Dixon AK. Grainger & Allison’s Diagnostic Radiology. 2008 (5th Ed). Churchill Livingstone. 9. Garg A, Gaikwad SB, Gupta V, Mishra NK, Kale SS, Singh J. Bipartite atlas with os odontoideum: Case report. Spine 2004;29(2):E35-8. 10. Currarino G, Rollins N, Diehl JT. Congenital defects of the posterior arch of the atlas: a report of seven cases including an affected mother and son. Am. J. Neuroradiol. 1994; 15:249–54. 11. Chu CY, Chan RTM, Fung VKP, Cheng CS. Congenital posterior arch defect of the atlas: Report of a rare anomaly. Hong Kong J Radiol. 2011;14:102-5. 12. Yochum TR, Rowe LJ. Yochum and Rowe’s essentials of skeletal radiology. 3rd Ed. Lippincott Williams & Wilkins. 2005 13. Senoglu M, Safavi-Abbasi S, Theodore N, Bambakidis NC, Crawford NR, Sonntag VK. The frequency and clinical signifcance of congenital defects of the posterior and anterior arch of the atlas. J Neurosurg Spine. 2007;7:399–402. 14. Cote P, Cassidy JD, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004; 112(3):267-73. 15. Gross A, Forget M, St George K, Fraser MM, Graham N, Perry L, Burnie SJ, Goldsmith CH, Haines T, Brunarski D. Patient education for neck pain. Cochrane Database Syst Rev. 2012;3:CD005106. doi: 10.1002/14651858.CD005106.pub4. SPINA BIFIDA OCCULTA GLOVER et al
CJA December 2012
CJA June 2013