Spine (Phila Pa 1976). 2009 Aug 15; 34(18): 1906-9Gubin AV, Ulrich EV, Taschilkin AI, Yalfimov ANSTUDY DESIGN: The results of MRI study of 10 children with acute stiff-neck who were treated in the Department of Spine Surgery in Saint-Petersburg State Pediatric Medical Academy. OBJECTIVES: To demonstrate the MRI findings in children with acute stiff neck and suggest other explanations to this findings. SUMMARY OF BACKGROUND DATA: The etiology of child's acute stiff-neck has been debated in the published data. Most authors supported the basic role of atlantoaxial fixation in this condition. But modern investigations using MRI and CT show another explanations. METHODS: A total of 10 patients aged 5 to 14 years with typical stiff neck with acute onset were studied by MRI in first 12 hours. RESULTS: In all 10 investigations typical changes that disappeared in a few days were found. There were triangle or oblong high intensity zone near the external edges of backbone discs C2-C3 or C3-C4. The zones were always on the side where the patients felt pain. CONCLUSION: In our opinion, the main reason of the child's acute stiff-neck is a rapid or gradual strangulation of the vascularized tissue in uncovertebral zones in C2-C3, C3-C4 caused by a head movement or a neck's prolonged incurvationed position during a profound sleep. It causes a "wedge" of hydropic tissues that irritate the back longitudinal ligaments. As the result, a head has antalgic position and, in the most severe cases, is blocked.
