Prevalence of Atlanto-Axial Instability and Its Association With Clinical Signs in Children With Down Syndrome

Abstract

Journal of Human Growth and Development, 2015; 25(2): 151-155 -151 - 2015; 25(2): 151-155 ORIGINAL RESEARCH Journal of Human Growth and Development ABSTRACTIntroduction: A change in the atlanto-axial alignment in children with Down syndrome may be associated with pain, neurological disorders, high spinal cord compression and sudden death. Objective: To determine the prevalence of atlanto-axial instability in children with Down syndrome and its association with the presence of signs and symptoms of atlanto-axial instability. Methods: A cross-sectional study evaluated 21 children with Down syndrome aged between 3 and 5 years. Children who had undergone cervical spine surgery or who had diseases not associated with this syndrome were excluded. Sex, age, ethnicity of the child and the presence of signs suggestive of atlanto-axial instability, as reported by caregivers, such as neck pain, difficulty walking, weakness in the lower limbs, fatigue, difficulty with balance, urinary and fecal incontinence and projectile vomiting were studied. Children underwent a cervical spine X-ray in the lateral view in three positions: neutral, flexion and extension. When the atlasodontoid distance was equal to or greater than 4.5 mm, atlanto-axial instability was diagnosed. Results: The prevalence of atlanto-axial instability in the studied population was 9.5%. There was no significant association revealed in the chi-square test between the signs suggestive of atlanto-axial instability and the presence of atlanto-axial instability (p > 0.05). Conclusions: Atlanto-axial instability is possibly not associated with its suggestive signs.Key words: Down Syndrome, Joint Instability, Atlanto-axial Joint, X-rays, Prevalence.

Fatores facilitadores, principais dificuldades e estratégias empregadas no aleitamento materno de bebês com síndrome de Down: uma revisão sistemática

“…Only one study (17) pointed at head and neck stabilization as a facilitating strategy for breastfeeding. The authors explained that stabilization is important in infants with DS, who are more likely to have malformations or ligamentous laxity in the first two cervical vertebrae (atlantoaxial instability (24) ), which can put pressure on the brain stem or spinal cord during flexion or excessive extension of the head. Another strategy cited by the authors (17) to provide stability to the baby's jaw and masseter support is to position the U-shaped hand with the index finger and thumb forming the U, and the baby's chin must be positioned in the concavity of the U.…”

Estimulação Precoce Sensorial Com Cavalos De Bebês Com Síndrome De Down

“…Para tal recomendação, consideram a possível existência de disfunção atlantoaxial em crianças com SD e seu difícil diagnóstico antes desta idade de 3 anos, o que favorece o risco de lesão (Defilipo et al, 2015). Entretanto, a North American Riding for the Handicapped Association (NARHA, 2003), ainda tendo em perspectiva a realização da montaria, defendeu o início da 709 terapia a partir de dois anos de idade, diante da incidência de 10 a 20 por cento da ocorrência de tal disfunção em crianças com SD.…”