Spontaneous rotatory atlantoaxial dislocation without neurological compromise in a child with Down syndrome: a case report

Abstract

Spontaneous atlantoaxial dislocation is a rare recognised complication of Down syndrome. In the majority of cases, dislocation takes place in an anteroposterior direction and is often associated with abnormalities of odontoid development or ossification. Rotatory atlantoaxial dislocation is extremely rare in Down syndrome and this is to our knowledge the first reported case in which modern imaging methods have been described; surface shaded reformats derived from a multislice CT scan were of fundamental importance in making the diagnosis.

Understanding the causes of obesity in children with trisomy 21: hyperphagia vs physical inactivity

“…In addition to this metabolic predisposition to weight gain, children and adolescents with trisomy 21 have been shown to participate in less high‐intensity physical activity than their siblings (Whitt‐Glover et al ) and do not meet the recommended daily requirements of moderate to vigorous physical activity (Esposito et al ; Nordstrom et al ). Although there are valid medical reasons for the lower level of exercise, such as the risk of atlantoaxial subluxation or dislocation (Semine et al ; Au‐Yong et al ), unfortunately, environmental factors may also play a role in preventing regular participation in physical activity for individuals with intellectual disability. Heller et al () reported that many adults with trisomy 21 are unaware of opportunities for engagement in team sports or gym programmes within the community or may have difficulty with independent exercise and require the support, or participation, of family and friends.…”

Spontaneous Ankylosis of Occiput to C2 following Closed Traction and Halo Treatment of Atlantoaxial Rotary Fixation

“…Atlantoaxial rotatory fixation (AARF) is an uncommon condition that usually occurs in children after an inflammatory upper respiratory tract infection or pharyngitis, but it can also be spontaneous or follow minor trauma or surgery on the oropharynx. 1 2 3 4 5 6 7 8 Fielding and Hawkins have classified AARF into four types on the basis of the rotational displacement and competency of the transverse ligament. 1 Most cases are thought to be the result of nonresolving acute atlantoaxial rotational subluxation or “acute torticollis.” Treatment usually consists of traction until reduction occurs, followed by immobilization in Minerva brace or halo vest.…”

Atlantoaxial Rotatory Instability in a Down Syndrome Patient with Aberrant Vertebral Artery Anatomy

“…Yong et al reported the successful use of halo traction to reduce AARS in a child with DS, Yamazaki et al could not achieve closed reduction with a halo vest in an adult with chronic AARS and resorted to open reduction with O-C3 fusion[11,15].…”