Cranio-vertebral pathology in Down syndrome

Cranio-vertebral malformations, especially atlanto-axial dislocation, are frequently seen in Down patients. However, symptomatic forms in mongolism are rare. Pyramidal signs have a signal value. In symptomatic malformations surgical treatment should be advised, i.e. posterior fixation after pre-operative reduction by traction or transoral odontoidectomy if no reduction is achieved.