The clinical significance of spina bifida occulta at C1: A case control study

Aim: The purpose of the paper was to investigate any correlation between spina bifida occulta of the atlas (SBO of C1) and the incidence of headaches or neck pain in a cohort of patients presenting for chiropractic treatment. Methods: A case control study design was selected for this research. Patients were selected retrospectively from those that had presented for chiropractic treatment at the Macquarie University chiropractic outpatient clinics. The presence of self-reported headache (HA) and neck pain (NP) at the time of initial consultation was compared in two groups of 32 subjects. All patients in the experimental group had SBO of C1 evident on x-ray; the control group was formed from gender matched patients whose x-rays did not show SBO of the atlas. Results: 50% of the experimental group reported neck pain or headache on initial consult compared to 46.9% in the control group. Statistical analysis indicated no significant difference in the frequency of headache or neck pain reported between the two groups.Conclusion: These results indicate that SBO of C1 does not appear to be associated with an increased presentation of headache or neck pain.