Functional Queckensted's test in rheumatoid atlanto-axial luxation

Queckenstedt's test was carried out in 15 patients with marked rheumatoid atlanto-axial luxation. The test was done when moving the neck stepwise between flexion and extension, and with the patient in both lateral and sitting positions. The test performed in the sitting position was termed the functional Queckenstedt's test. The flexed position of the neck and the sitting body position, either alone or in combination, were factors contributing to a manometric block. Six more block phenomena were recorded in the sitting compared with the lateral position. As the sensitivity of the test seemed unaffected by body position, this indicated an increased atlanto-axial luxation in the sitting position. This applied to the neutral as well as the flexed position of the neck. There was a fairly good correlation between neurological symptoms and signs and the functional Queckenstedt's test. The use of the test as an aid supplmentary to the clinical and roentgenological findings when deciding on the treatment of patients with rheumatoid atlanto-axial luxation is outlined.