Atlanto-occipital Hypermobility in Subjects With Downʼs Syndrome

Matsuda, Yoshiro; Sano, Nozomi; Watanabe, Shohei; Oki, Sadaaki; Shibata, Taihoh

doi:10.1097/00007632-199511000-00004

Cited by 28 publications

(9 citation statements)

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“…Only 1 of the 38 subjects with Down syndrome was symptomatic. 31 Os odontoideum and odontoid hypoplasia are other well-described causes of surgical instability and underlying stenosis in Down syndrome patients. 32 -34 A proposed algorithm for treatment of pediatric patients was compiled by Pizutillo and Herman in 2005.…”

Section: Down Syndromementioning

confidence: 99%

Review of Cervical Spine Anomalies in Genetic Syndromes

McKay¹,

Alomari²,

Tomlinson³

et al. 2012

Spine

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Section: Down Syndromementioning

confidence: 99%

Review of Cervical Spine Anomalies in Genetic Syndromes

McKay¹,

Alomari²,

Tomlinson³

et al. 2012

Spine

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“…[11,17,24,30,42,43] Clinical correlations were not made in the first description of antlantooccipital luxation by Spitzer, et al [40] Neurological abnormalities have been found in up to 66% of patients with antlantooccipital pitoatlantal instability. [30] In a prospective review of 64 patients with antlantooccipital instability, 61% of the patients were shown to have a posterior occipital subluxation greater than 4 mm and 21% to have a predental space of greater than 5 mm.…”

Section: Discussionmentioning

confidence: 99%

Instability of the craniovertebral junction and treatment outcomes in patients with Down's syndrome

Taggard¹,

Menezes²,

Ryken³

1999

FOC

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Operative intervention for the treatment of instability at the craniovertebral junction in patients with Down's syndrome has become somewhat controversial because some authors have reported high surgery-related complication rates and suggested that the incidence of neurological abnormality associated with this abnormal motion may be low. In this report, the authors describe the clinical and radiographic findings in 33 patients treated at their institution. Common presenting symptoms included neck pain (14 patients), torticollis (12 patients), and myelopathy manifested as hyperreflexia (21 patients), or varying degrees of quadriparesis (11 patients). Four patients suffered acute neurological insults, two after receiving routine general anesthetics for minor surgical procedures and two other patients following minor falls. Atlantoaxial instability was the most common abnormality documented on radiography (22 patients). Atlantooccipital instability (15 patients) was also frequently observed and was coexistent with the presence of atlantoaxial luxations in 14 patients. A rotary component of the atlantoaxial luxation was present in 13 cases. In 17 patients bony anomalies were present, the most frequent of which was os odontoideum (10 patients). Twenty-four patients underwent operative intervention, and successful fusion was achieved in 23. In six of nine patients with basilar invagination, reduction was achieved with preoperative traction and thus avoided the need for ventral decompressive procedures. There were no cases of postoperative deterioration, and 22 patients made excellent or good recoveries. The results of this series highlight the clinicopathological phenomena of craniovertebral instability in patients with Down's syndrome and suggest that satisfactory outcomes can be achieved with a low rate of surgical morbidity.

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“…Widening of the anterior atlanto-odontoid distance (AAOD), and atlanto-occipital instability occur in up to 21% and 63% of Down patients, respectively, but neurological complaints are uncommon and rarely severe enough to contribute to the patient's demise [17]. In a study on atlanto-occipital mobility, performed in 57 patients with Down's syndrome, it has been observed that this alteration is asymptomatic in the majority of the subjects with Down's syndrome, but the possibility of neurologic complications should be considered [18].…”

Section: Role Of Cervical Spine Radiographymentioning

confidence: 99%

Preanesthetic Evaluation and Assessment of Children with Down's Syndrome

Santamaria

Paola

Mafrica

et al. 2007

The Scientific World JOURNAL

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During preoperative evaluation for anesthesia in the Down patient, it is important to focus attention on the functional conditions of the patient and systems that frequently show anomalies. One of the challenges of evaluating pre-operative conditions and potential risks in the Down patient is the lack of a gold-standard evaluation score; cervical spine abnormalities, reduced dimensions and malformations of the airways, neurological changes, respiratory and cardiac disease, as well as endocrinological and metabolic alterations. We suggest, as a possible method of evaluation for patients with mental retardation and possible malformations, a new scale which takes the functional and mental conditions into account: the Sensorial, Psychological, Anatomical, Biological, Operational and Surgical (SPABOS) Compliance Score.

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Atlanto-occipital Hypermobility in Subjects With Downʼs Syndrome

Cited by 28 publications

References 0 publications

Review of Cervical Spine Anomalies in Genetic Syndromes

Review of Cervical Spine Anomalies in Genetic Syndromes

Instability of the craniovertebral junction and treatment outcomes in patients with Down's syndrome

Preanesthetic Evaluation and Assessment of Children with Down's Syndrome

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