Cervical-spine instability in children with Down syndrome (trisomy 21).

Semine, A A; Ertel, Alan N.; Goldberg, Mordechai; Bull, M J

doi:10.2106/00004623-197860050-00010

Cited by 127 publications

(67 citation statements)

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“…This explains why the upper limit of the normal AAOD is greater in children than in adults. Second, there is diminished incidence of AAI with age, even with applying different threshold values for children and adults [6,10,21]. However, this observation was not consistent in longitudinal studies.…”

Section: Discussionmentioning

confidence: 95%

“…AAI is primarily caused by laxity of the transverse atlantal ligament. This is part of the general ligamentous laxity characteristic of DS that often results in hyperflexibility of joints [21]. Bony abnormalities of the C1-C2 region, which are common in DS, may play a part in AAI [18].…”

Section: Discussionmentioning

confidence: 99%

“…The association was first reported in 1961 [23], almost 100 years after DS was described. Although numerous reports followed [11,17,21], AAI came into the limelight only in 1983 when the Special Olympics prohibited DS individuals having the condition from participating in certain neck-stressing sports [22]. AAI, which affects 10-20% of individuals with DS, is mostly asymptomatic and is diagnosed using radiography [1,4,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Cervical spine abnormalities associated with Down syndrome

Ali

Al-Bustan

Al-Busairi

et al. 2006

International Orthopaedics (SICO

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Atlantoaxial instability (AAI) affects 10-20% of individuals with Down syndrome (DS). The condition is mostly asymptomatic and diagnosed on radiography by an enlarged anterior atlanto-odontoid distance. Symptomatic AAI, which affects 1-2% of individuals with DS, manifests with spinal cord compression. Cervical spondylosis, which is common in DS, also has the potential for cord damage but it has received less attention because paediatric populations were mostly studied. Forty-four Kuwaiti subjects with DS, whose ages were ≥15 years, were evaluated clinically and radiographically. Lateral neck radiographs were taken in the neutral and flexion positions. Asymptomatic AAI was diagnosed in eight subjects (18%) and congenital anomalies of C1-2 were found in five (12%). Five patients had AAI in flexion only while three patients had it in both views. Three patients with AAI had odontoid anomalies contributing to the condition. When assessing AAI, the posterior atlanto-odontoid distance has to be considered because it indicates the space available for the cord. Cervical spondylosis was noted in 16 (36%) subjects. Degenerative changes increased with age, occurred earlier than in the normal population, and affected mostly the lower cervical levels. Half the patients with AAI had cervical spondylosis, a comorbidity that puts the cord at increased risk.Résumé L'instabilité de la charnière occipito atloïdienne affecte 10 à 20% des sujets présentant un Down syndrome (trisomie 21). Cette instabilité est souvent asymptomatique et seulement diagnostiquée sur les radiographies qui montrent un élargissement de la distance antérieure atloïdo-odontoide. L'asymptologie de l'instabilité occipito atloïdienne affecte 1 à 2% des sujets présentant un Down syndrome avec des signes manifestes de compression médullaire. La spondylose cervicale qui est habituelle dans le Down syndrome peut potentialiser des lésions de la moelle. 44 sujets Koweitis présentant un Down syndrome dont l'âge était supérieur à 15 ans ont été évalués cliniquement et radiographiquement. Des radiographies de la colonne cervicale de profil ont été effectuées en position neutre et en position de flexion. Une instabilité occipito atloïdienne a été diagnostiquée chez 8 sujets (18%) avec des anomalies congénitales de C1 C2, chez 5 sujets (12%). 5 patients présentaient une instabilité uniquement en flexion et 3 patients présentaient une telle instabilité sur tous les clichés. 3 patients avec une instabilité occipito atloïdienne présentaient des anomalies de l'odontoide aggravant encore les conditions locales. Lorsqu'il existe une instabilité occipito atloïdienne, la distance C1 odontoide doit être évaluée car elle indique l'espace possible pour la moelle. Une spondylolyse cervicale a été relevée chez 16 patients (36% des sujets). Avec l'âge, les lésions dégénératives peuvent évoluer, survenant plus tôt que dans la population normale et peuvent léser les différents niveaux de la colonne cervicale. La moitié des patients avec une instabilité occipito atloïdienne ont un...

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cervical spine abnormalities associated with Down syndrome

Ali

Al-Bustan

Al-Busairi

et al. 2006

International Orthopaedics (SICO

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“…The prevalence of asymptomatic atlanto-occipital instability is relatively common in individual with Down syndrome, exists in 10 to 20% of the cases [2][3][4] . The rate of symptomatic atlanto-occipital instability is approximately 1-2%.…”

Section: Introductionmentioning

confidence: 99%

Atlantoaxial Instability in a Patient With Down's Syndrome

Yıldız¹,

Havan²,

Toprak³

et al. 2014

Sakarya Med J

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“…Down's syndrome is associated with multiple cervical abnormalities including ligamentous laxity [1], congenital fusion [2] and bony hypoplasias [3]. These entities occur with an approximate incidence of 40% [4].…”

Section: Introductionmentioning

confidence: 99%

C2/3 Instability in a Child with Down’s Syndrome

Citow

Munshi²,

Chang-Stroman³

et al. 1998

Pediatr Neurosurg

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Down’s syndrome patients are prone to cervical ligamentous laxity, the vast majority of which is at the C1/2 level. We describe the case of a 2-year-old girl with Down’s syndrome who was found to have cervical instability at the C2/3 level on screening cervical spine radiographs with 9 mm of anterolisthesis of C2 on C3. She was without clinically evident neurological deficit from this condition; however, T₂-weighted magnetic resonance imaging of her cervical spine revealed high intensity signal changes within the spinal cord at and above that level. She underwent posterior fusion that was complicated by poor tolerance of her Minerva-type cervical brace. She eventually developed a stable fusion with 5 mm of anterolisthesis at the C2/3 level. This is the only Down’s syndrome patient with instability at the C2/3 level that we have found reported. Our experience suggests that Down’s syndrome patients can have instability at C2/3 that can be successfully treated with posterior fusion.

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Cervical-spine instability in children with Down syndrome (trisomy 21).

Cited by 127 publications

References 0 publications

Cervical spine abnormalities associated with Down syndrome

Cervical spine abnormalities associated with Down syndrome

Atlantoaxial Instability in a Patient With Down's Syndrome

C2/3 Instability in a Child with Down’s Syndrome

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