Cary Daily Times ( Events News Weather Sports and Featured Columns for Cary, NC)

There has been recent debate about the role chiropractic healthcare should have in the care of children.  Recently, as a means of cutting expenses in state government, the North Carolina General Assembly has proposed legislation in the Senate that would make chiropractic coverage under the state health plan only for children greater than 5 years of age.  This is absolutely absurd, insane!  Are children under 5 years old now considered invertebrates?

Are you familiar with “Sudden Infant Death Syndrome” or SIDS?  This is where an infant will die in his bed at a very early age and for no known cause.  Why would I bring that up in a column about chiropractic health? They are probably more closely related than you may think.

What causes SIDS?  The answer is not that simple, but some of the research to date focuses on a very credible possible cause; atlanto-occipital hypermobility.  In one study the authors describe the phenomenon of “atlas inversion.” ¹  This is where posterior arch of the atlas (or C1 - the upper-most vertebra in the spinal column) enters the foramen magnum (the hole in the bottom of the skull). Try to imagine two rings one over the other with a rope almost the size of the inner circumference of the rings running down through both of the rings.  The bottom ring represents the atlas while the upper ring represents the foramen magnum of the skull, just below the brain.  The rope represents the spinal cord.  Now imagine the lower ring, instead of being in its normal horizontal position is instead positioned into a nearly vertical position with part of its surface extending into the inside of the ring above it, putting a kink in the rope.  (Remember that the rope represents the spinal cord.)

Anatomically, the atlas is situated at the level of the brain stem (the part of the brain that controls such things as breathing and heart function).  Other nerves also run through this area and it is location the greatest convolution of the vertebral arteries - the primary blood supplies to the posterior brain.

You can see the potential for damage in this area from forceful deliveries! *

Dr. Abraham Towbin² , Dr. Floyd Gilles³ and many others have contributed greatly to our understanding of birth trauma and their implications in SIDS deaths.  Chiropractic pediatric specialists believe that the subluxations in newborns should be analyzed and corrected as soon as possible after birth to prevent ongoing problems in the growing child.⁴

In yet another study, fifty deceased infants were x-rayed and it was found that all cases of atlas inversion⁵ were SIDS cases, but not all SIDS deaths exhibited atlas inversion.   This means that atlas instability, a key feature of the Vertebral Subluxation Complex, is a possible cause of Sudden Infant Death Syndrome.  Death would have to be, in my estimation, the most serious complication of a vertebral subluxation.  But while it is not THE cause of SIDS, subluxation certainly is strongly implicated.   It is also plausible to conclude that other, more conventional, diseases in the survivors of birth trauma could have this as their root cause.

Of course, birth trauma is not the only source of childhood subluxations.  Other traumatic events of childhood may include motor vehicle accidents (MVA’s),^6,7    sports injuries, slip and falls, etc.  Interestingly, the authors of one study on children in MVA’s noted that the younger children (ages 2 to 4 for the study) sustained more severe injuries.⁸

Any parent, or anyone who has ever been a child (that would include most of us) knows that accidents happen and they are not always auto accidents.  Not only birth trauma and motor vehicle accidents cause childhood spinal trauma, but falls from the trees, contact sports, those double-dog-dares when you are riding your bike (a 1-speed with the extended forks, banana seat and sissy bar) not to jump that ravine that looks like a canyon (I guess the secret had to get out sooner or later), they all make up part of being a kid.  (OK, OK.  I used to be a kid.)

The Council on Chiropractic Practice Clinical Practice Guideline states, “Since vertebral subluxation may affect individuals at any age, chiropractic care may be indicated at any time after birth.” ⁹

To not include children in chiropractic care is down-right irresponsible!

*NOTE: Please do not misinterpret the author’s intention.  In no way are we advocating for cesarean over natural delivery as there are inherent dangers to not only the mother which is obvious, but also to the child.  C-section infants have been found to have abnormally lower blood pressure measurements than those born naturally and have a lower metabolic activity of certain immune factors which may leave the child open to infectious disease.

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  ¹Schneier M, Burns RE: Atlanto-Occipital Hypermobility in sudden Infant Death Syndrome. Chiropractic : J Chiro Research and Clinical Investigation. 1991; 7(2):33.
  ²Towbin A. Latent Spinal Cord and Brain Stem Injury in Newborn Infants. Develop Med Child Neurol 1969; 11:54.
  ³Gilles FH, Bina M, Sotrel A.”Infantile Atlanto-Occipital Instability: The Potential Danger of Extreme Extension.” Am J Dis Child 1979; Vol 133: pp30-7.
  ⁴McMullen M. “Physical Stresses of Childhood that Could Lead to the Need for Chiropractic Care.” Proceedings of the National Conference on Chiropractic and Pediatrics, San Diego, California. Int Chiropractors Assoc. 1991.
  ⁵Hospers LA, et.al. “Atlanto-Occipital Hypermobility In Sudden Infant Death Syndrome” Today’s Chiropractic Jan/Feb,  1990; 19 (1):36-40.
  ⁶Orenstien JB, Klein BL, Gottschall CS, et.al. Age And Outcome in Pediatric Cervical Spine Injury; 11-year experience. Pediatr Emerg Care 1994; 10(3):132.
  ⁷Glass RB, Sivit CJ, Sturm PF, et.al. Lumbar Spine Injury in a Pediatric Population: Difficulties With Computed Tomographic Diagnosis. J Trauma 1194; 37(5):815
  ⁷Orenstien JB, Klein BL, Gottschall CS, et.al. Age and Outcome in Pediatric Cervical Spine Injury; 11-year experience. Pediatr Emerg Care 1994; 10(3):132.
  ⁹Kent C, et.al. Chiropractic Care of Children. Clinical Practice Guideline: Vertebral Subluxation in Chiropractic Practice 1998: pp87-90.
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Dr. George Ellwanger lives in Cary, North Carolina with his wife and children.  Before receiving his Doctor of Chiropractic Degree from Palmer College of Chiropractic, he completed undergraduate and graduate studies at Appalachian State University then served in the U.S. Air Force.
Dr. Ellwanger is one of only a few hundred Board Certified Alas Orthogonists world-wide.
Contact Dr. Ellwanger at 919-468-0903 or via email at atlasdoc@nc.rr.com.