Craniovertebral Junction and Cervical Spine Injuries Associated with some YOGA Asanas: Two Case Reports and Literature Review

Objective:The main purpose of our case reports and literature review is to make individuals aware about possible catastrophic events which may be associated with some particular Yoga asanas, which result too much straining on craniovertebral junction and cervical spine, particularly in individuals with congenital anomalies of craniovertebral junction and cervical spine as well as osteoporotic and degenerative weakness of this region. Method:We presented our two case reports and literature review of case reports of compressive myelopathy and vascular accidents of this region associated with various Yoga asanas .Results: Both of the patients in our case reports had Os odontoideum, one was taking steroid for bronchial asthma and they were practicing Sirsasana (Headstand) and Halasana (plow pose).In review of literature we found four cases of compressive myelopathy, two cases were associated with multilevel cervical spondylosis and other two cases were associated with osteoporosis.Three of these patients were practicing Sirsasana (Headstand) and one Halasana (plow pose).We also found three cases of vascular accidents at craniovertebral junction.Two cases related to vertebral artery and one related to basilar artery while practicing Setubandha (Bridge pose), Sarvangasana (Shoulder stand) and Sirsasana (Headstand) respectively. Conclusion:Though yoga practices are considered safe and without harmful effects, some yoga asanas, resulting significant strain on craniovertebral junction and cervical spine, may land up individuals in catastrophic complications such as quadriparesis, stroke and respiratory paralysis with ventilator dependency.Individuals wishing to commence these asanas should have prior proper assessment osteoligametous structures of this region to rule out underlying osteoporosis, any osseous pathology, congenital osseous malformations, basilar invagination, vascular malformations etc.