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Related Experiment Videos

Atlantooccipital instability in Down syndrome.

D M Rosenbaum, J D Blumhagen, H A King

    AJR. American Journal of Roentgenology
    |June 1, 1986
    PubMed
    Summary

    Atlantooccipital instability, rare in non-traumatic cases, was observed in two children with Down syndrome. Careful assessment of this joint is crucial, particularly after cervical fusion.

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    Area of Science:

    • Orthopedics
    • Pediatric Radiology
    • Genetics

    Background:

    • Atlantooccipital instability is a rare but severe condition, typically resulting from major trauma.
    • Nontraumatic atlantooccipital instability is exceptionally uncommon.
    • Down syndrome is associated with an increased risk of cervical spine abnormalities.

    Observation:

    • Two pediatric patients with Down syndrome presented with significant atlantooccipital subluxation.
    • The subluxation was clearly demonstrated on flexion and extension radiographic views of the cervical spine.
    • This finding highlights a potential complication in individuals with Down syndrome.

    Findings:

    • Striking atlantooccipital subluxation was identified in the two children with Down syndrome.
    • The instability was evident during dynamic imaging (flexion/extension radiographs).
    • This suggests a specific vulnerability of the atlantooccipital joint in this population.

    Implications:

    • Increased radiologic evaluation of cervical spine stability is warranted for individuals with Down syndrome, especially those considering athletic participation.
    • The atlantooccipital joint requires careful assessment for instability, even in the absence of major trauma.
    • Post-surgical assessment, particularly after C1-C2 fusion, must include evaluation of the atlantooccipital joint to rule out subluxation.

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