Lumbar Spondylolysis and Spondylolisthesis in Down Syndrome: A Cross-sectional Study at One Institution

Hansdorfer, Marek A.; Mardjetko, Steven; Knott, Patrick; Thompson, Samantha E.

doi:10.1016/j.jspd.2013.05.011

Cited by 5 publications

(6 citation statements)

References 17 publications

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“… 25 A recent study also found that smaller relative anterior‐posterior size, observed in late‐walking women in this study, was also associated with spondylolysis. 26 A number of clinical groups with delayed ambulation including Down syndrome, 27 osteogenesis imperfecta, 28 and dyskinetic cerebral palsy 29 have increased risk of spondylolysis and/or isthmic spondylolisthesis, therefore motor deficits in early life may contribute to these problems. If delayed motor development is shown to influence spondylolysis risk in late walkers, there may be interventional opportunities to minimize these effects.…”

Section: Discussionmentioning

confidence: 99%

Motor development in infancy and spine shape in early old age: Findings from a British birth cohort study

Saunders

Gregory

Pavlova

et al. 2020

Journal Orthopaedic Research

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Spine shape changes dramatically in early life, influenced by attainment of developmental milestones such as independent walking. Whether these associations persist across life is unknown. Therefore, we investigated associations between developmental milestones and spine shape, as determined using statistical shape models (SSMs) of lumbar spine from dual‐energy X‐ray absorptiometry scans in 1327 individuals (688 female) at 60 to 64 years in the MRC National Survey of Health and Development. Lumbar lordosis angle (L4 inferior endplate to T12 superior endplate) was measured using the two‐line Cobb method. In analyses adjusted for sex, height, lean and fat mass, socioeconomic position, and birthweight, later walking age was associated with greater lordosis described by SSM1 (regression coefficient, 0.023; 95% CI, 0.000‐0.047; P = .05) and direct angle measurement. Modest associations between walking age and less variation in anterior‐posterior vertebral size caudally (SSM6) were also observed (0.021; 95% CI, −0.002 to 0.044; P = .07). Sex interactions showed that later walking was associated with larger relative vertebral anterior‐posterior dimensions in men (SSM3; −0.043; 95% CI, −0.075 to 0.01; P = .01) but not women (0.018; 95% CI, −0.0007 to 0.043; P = .17). Similar associations were observed between age at independent standing and SSMs but there was little evidence of association between sitting age and spine shape. Unadjusted associations between walking age and SSMs 1 and 6 remained similar after adjustment for potential confounders and mediators. This suggests that these associations may be explained by altered mechanical loading of the spine during childhood growth, although other factors could contribute. Early life motor development, particularly walking, may have a lasting effect on the features of spine morphology with clinical significance.

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Section: Discussionmentioning

confidence: 99%

Motor development in infancy and spine shape in early old age: Findings from a British birth cohort study

Saunders

Gregory

Pavlova

et al. 2020

Journal Orthopaedic Research

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“…The incidence of spondylolysis and spondylolisthesis in the general population is 3-6% and 2.7-8.4%, respectively. 59 A cross-sectional study by Hansdorfer et al demonstrated the incidence of spondylolysis and spondylolisthesis in patients with Down syndrome to be 18.7% and 32.7%, respectively. 59 Interestingly low back pain and leg pain were more frequent in Down syndrome patients with spondylolisthesis than in patients with spondylolisthesis in the general population.…”

Section: Spondylolysis/spondylolisthesismentioning

confidence: 99%

“…59 A cross-sectional study by Hansdorfer et al demonstrated the incidence of spondylolysis and spondylolisthesis in patients with Down syndrome to be 18.7% and 32.7%, respectively. 59 Interestingly low back pain and leg pain were more frequent in Down syndrome patients with spondylolisthesis than in patients with spondylolisthesis in the general population. 59 There have been no studies to date regarding treatment of spondylolysis or spondylolisthesis specifically in patients with Down syndrome.…”

Section: Spondylolysis/spondylolisthesismentioning

confidence: 99%

Orthopaedic Management in Down Syndrome

Rako¹,

Ranade²,

Allen³

2021

Journal of the Pediatric Orthopaedic Society of North America

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Down syndrome is the most common chromosomal disorder and typically results from a maternal duplication of chromosome 21 yielding trisomy 21. General features include a flat facial profile, short stature, oblique palpebral fissures, epicanthal folds, and associated medical conditions such as congenital heart disease, vision problems, and hearing loss. Most musculoskeletal manifestations of Down syndrome are related to generalized ligamentous laxity, joint hypermobility, and hypotonia which can lead to atlantoaxial instability, atlanto-occipital instability, scoliosis, spondylolisthesis, hip dysplasia / instability, patellar instability, pes planus, and hallux valgus. Importantly, the orthopaedist may also be the first to discover systemic conditions such as hypothyroidism associated with slipped capital femoral epiphysis (SCFE) or leukemia or inflammatory arthritis leading to musculoskeletal pain . The purpose of this review is to summarize what the orthopaedist needs to remember when evaluating and treating their patients with Down Syndrome.

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“…People with Down syndrome may have specific risks for experiencing chronic pain because of increased risk of potentially painful conditions. These are synthesized here with approximate prevalence vales: congenital heart anomalies (15%), acquired cardiac disease (16%), chronic pulmonary changes (30%), osteoarthritic degeneration of the spine (32%), osteoporosis with resultant fractures of the long bones (55%) or vertebral bodies (30%), untreated atlanto-occipital instability (8%), eye problems (36%), celiac disease (11%), eczema (23%) (see for example; van Allen et al, 1999 ; Henderson et al, 2007 ; Hansdorfer et al, 2013 ).…”

Section: Pain In Intellectual Disability and Down Syndromementioning

confidence: 99%

Pain perception in people with Down syndrome: a synthesis of clinical and experimental research

McGuire

Defrin

2015

Front. Behav. Neurosci.

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People with an intellectual disability experience both acute and chronic pain with at least the same frequency as the general population. However, considerably less is known about the pain perception of people with Down syndrome. In this review paper, we evaluated the available clinical and experimental evidence. Some experimental studies of acute pain have indicated that pain threshold was higher than normal but only when using a reaction time method to measure pain sensitivity. However, when reaction time is not part of the calculation of the pain threshold, pain sensitivity in people with Down syndrome is in fact lower than normal (more sensitive to pain). Clinical studies of chronic pain have shown that people with an intellectual disability experience chronic pain and within that population, people with Down syndrome also experience chronic pain, but the precise prevalence of chronic pain in Down syndrome has yet to be established. Taken together, the literature suggests that people with Down syndrome experience pain, both acute and chronic, with at least the same frequency as the rest of the population. Furthermore, the evidence suggests that although acute pain expression appears to be delayed, once pain is registered, there appears to be a magnified pain response. We conclude by proposing an agenda for future research in this area.

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Lumbar Spondylolysis and Spondylolisthesis in Down Syndrome: A Cross-sectional Study at One Institution

Cited by 5 publications

References 17 publications

Motor development in infancy and spine shape in early old age: Findings from a British birth cohort study

Motor development in infancy and spine shape in early old age: Findings from a British birth cohort study

Orthopaedic Management in Down Syndrome

Pain perception in people with Down syndrome: a synthesis of clinical and experimental research

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