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Atlanto-axial subluxation in Down's syndrome
J Shikata1, T Yamamuro, Y Mikawa
1Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan.
International Orthopaedics
|January 1, 1989
Summary
Surgery effectively treated symptomatic atlanto-axial subluxation in Down syndrome patients with bony anomalies. Early surgical stabilization improved symptoms and achieved bony union in all cases.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Genetics
Background:
- Atlanto-axial subluxation is a concern in Down syndrome due to ligamentous laxity and congenital anomalies.
- Symptomatic atlanto-axial subluxation requires prompt management to prevent neurological damage.
Observation:
- Eight patients with Down syndrome and symptomatic atlanto-axial subluxation underwent surgical treatment.
- Congenital bony anomalies were consistently identified in all patients.
- Myelopathy was observed in five patients, with varying severity.
Findings:
- Posterior arthrodesis (C1-C2 or occiput-C2) was successfully performed in all eight patients.
- Excellent bony union was achieved in all cases.
- Significant improvement in symptoms was reported post-operatively.
Implications:
- Early surgical stabilization is recommended for symptomatic atlanto-axial subluxation in Down syndrome patients with osseous anomalies and ligamentous laxity.
- Surgical intervention can effectively prevent or mitigate spinal cord damage.
- This approach offers a favorable prognosis for patients with this complex condition.