Tahar M. Role of ultrasonography in the diagnosis of traumatic injury of thte upper cervical spine in children

Aim: Improvevent of the diagnosis of atlanto-axial rotary subluxation in newborn and preschool children by developing criteria to assess the position of the odontoid process, and to evaluate ligaments, spinal canal and spinal cord at the atlanto-axial articulation. Shown that, when rotatory atlanto-axial subluxation occurs, this results in the asymmetry of the of the lateral masses of C1 with respect to the odontoid process of more than 1 mm, or 15%, the index D1/D2 is less than 0.80, the decrease of the space between the odontoid process and the transverse ligament,and in the asymmetry of thickness of the alar ligaments . Signs of severe form of rotatory atlanto-axial subluxation are asymmetry of the of the lateral masses of C1 with respect to the odontoid process of more than 3.0 mm or 50%, the index D1/D2 is less than 0.60, the lack of visualization of the of the space between the odontoid process and the transverse ligament, local fibrouses of the transverse ligament, deformation of the anterior dural space, the increase in the index of the posterior dural space / anterior dural space more than 1.5. It is established that in long-term after the treatment of rotatory atlanto-axial subluxation appears instability of atlanto-axial articulation, which is best determined by functional tests with the rotation of the head. Revealed that when atlanto-axial instability occurs, a blood flow disturbance appears at the third segment of the vertebral artery, which manifests in functional tests by a decrease in vessel diameter less than 1.5 mm, an increase in systolic blood flow velocity over 55 cm / s or a decrease of less than 15 cm / s, and an increase in the resistance index more than 0 .75, or a decrease of less than 0.55. Key words: rotary atlanto-axial subluxation, atlanto-axial articulation, ultrasonography.