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Down syndrome. Cervical spine abnormalities and problems.

D C Van Dyke1, C A Gahagan

  • 1Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City 52242.

Clinical Pediatrics
|September 1, 1988
PubMed
Summary
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Down syndrome (DS) individuals aged 5-21 showed atlantoaxial instability in 9% of cases. Adults with DS exhibited degenerative cervical spine changes, highlighting the need for regular screening in children and adults.

Area of Science:

  • Orthopedics
  • Radiology
  • Genetics

Background:

  • Down syndrome (DS) is associated with various skeletal abnormalities.
  • Atlantoaxial instability (AAI) and cervical spine degeneration are potential concerns in DS.

Purpose of the Study:

  • To evaluate the prevalence of atlantoaxial instability in children with DS.
  • To assess degenerative changes in the cervical spine of adults with DS.
  • To recommend appropriate radiographic screening protocols.

Main Methods:

  • Radiographic review of cervical spines in 34 children (5-21 years) with DS.
  • Radiographic review of cervical spines in adults (26-42 years) with DS.
  • Analysis of atlantoaxial subluxation and degenerative changes.

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Main Results:

  • 9% of DS children (5-21 years) exhibited atlantoaxial subluxation (>5 mm).
  • DS adults (26-42 years) showed no subluxation but significant degenerative changes, including spur formation and disc space narrowing.
  • Cervical spine issues are prevalent in both pediatric and adult DS populations.

Conclusions:

  • Baseline cervical spine radiography is recommended for DS children over 5 years.
  • Radiographic evaluation of the cervical spine should be considered for DS adults, especially those over 30.
  • Clinical evaluation for cervical pain or neurologic symptoms should prompt immediate cervical spine assessment in DS individuals.