Birth though miraculous can at times be slightly traumatic to the child. Many parents may report “ a difficult birth” which could mean the labor was lengthy in time, the position of the child was not ideal, they needed to be manually turned or extracted amongst a host of other scenarios.
In utero constraint, birth trauma, and a child’s everyday activities or specific types of sports or recreational injuries can all potentially lead to misalignment of the spinal joints. The specific signs associated with spinal subluxation can include pain, limitation of motion, and localized tenderness. Parents may also note inability to turn the head properly, difficulty latching when breast feeding or the baby may seems slightly distressed when attempting to roll over crawl or ambulate in any way. These physical manifestations can vary somewhat in the newborn compared to an adult or adolescent. The positional displacement of the spinal segment can be assessed through observation, palpation, and in radiographs once a child has reached an age where they are clinically acceptable which would note altered patterns of movement, fixation dysfunction, and hypermobility or instability and in some cases gross changes in spinal position can often be detected posturally (eg, structural scoliosis).
In some newborn patients the normal elasticity of the neonatal spine exceeds that of the stretch of the spinal cord, leading to severe injury. This can occur in the absence of significant radiographic alterations and is referred to as spinal cord injury without radiographic abnormality (SCIWORA).