Hyper Extension of the Upper Cervical Spine

Hyper extension of the upper cervical spine can cause many symptoms such as sub occipital muscular pain, tension headaches, cervicogenic headaches, dizziness, nausea, nystagmus, blurred vision and various other radicular symptoms. This needs to be analysed when considering extension traction for loss of lordosis in the cervical curve. If approximation of the C1 spinous process to the base of the skull is noted when viewing the lateral cervical x-ray, further extension in this area, especially during traction, may induce the previously mentioned symptoms with adverse effects.

When using the cervical Denneroll, actively tucking your chin is a technique that can be used to prevent hyper-extension of the upper cervical spine during Denneroll extension traction. This technique can also be used as a rehabilitative exercise.

Hyper-extension of the upper cervical spine may contra-indicate weighted traction on the cervical Denneroll (such as using a chin strap). This is because the patient loses the ability to tuck their chin during weighted traction. Pope-2 way cervical traction is very effective at creating traction toward cervical lordosis while minimizing or preventing further compressive extension to the upper cervical spine.

Shown is a post traction x-ray after using Pope – 2 way traction. You can note a significant reduction in the cervical kyphosis whilst the approximation of the C1 spinous process to the base of the skull is also reduced. This patient is a 37 mother of 2 who has been suffering from chronic migraines (motion and light sensitive) 3-5 x per week for 6 months. After analyzing her x-rays, compression extension traction for the cervical spine was ruled out. After initial improvements using the Cervical Denneroll at home, weighted traction with the cervical Denneroll was attempted but ruled out as her migraines were induced during the traction which can be attributed to compressive extension generated in the upper cervical spine during the traction. The patient also noted the occasional migraine during home use of the Denneroll as well. Pope- 2 way traction was then adopted without inducing symptoms and the ‘chin tuck’ technique for home use of the cervical Denneroll was then adopted. The patient is also doing assisted Thoracic Denneroll traction on the 3D-Denneroll table to help with her rounded shoulder posture. Note that support of the head is used during this traction to prevent hyper-extension of the upper cervical spine.

The patient became symptom (migraine) free after the first week (3 x per week) of traction and has not had a migraine for 3 weeks now. Her care in office and at home is being continued. The patient is also using the Pro-Lordotic Neck Exerciser (PLE) to assist her muscular rehabilitation. Prevention of the upper cervical spine is also easily controlled using the PLE.

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