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Atlantoaxial instability in Down's syndrome: a five year follow up study
R E Morton1, M A Khan, C Murray-Leslie
1Ronnie MacKeith Child Development Centre, Derbyshire Royal Infirmary.
Archives of Disease in Childhood
|February 1, 1995
Summary
Atlantoaxial instability (AAI) screening in children with Down
Area of Science:
- Pediatric Orthopedics
- Genetics
- Radiology
Background:
- Atlantoaxial instability (AAI) is a concern in children with Down syndrome.
- Previous studies have investigated the prevalence and progression of AAI in this population.
Purpose of the Study:
- To assess the five-year progression of atlantoaxial instability in children with Down syndrome.
- To evaluate the reliability of serial radiography in detecting changes in the atlanto-axial gap.
Main Methods:
- Longitudinal study involving repeat radiography over five years.
- Assessment of 67 children with Down syndrome initially screened for AAI.
- Analysis of changes in the atlanto-axial gap and development of symptomatic AAI.
Main Results:
- A significant reduction in the atlanto-axial gap was observed over five years.
- No new cases of AAI developed in children with initially normal radiography.
- One child developed acute symptomatic AAI post-surgery, highlighting a different risk profile.
Conclusions:
- Serial radiography can identify children with chronic AAI at risk of gradual symptom development.
- Screening programs may be justified for detecting chronic AAI.
- Acute symptomatic AAI post-trauma or anesthesia requires distinct management strategies, independent of prior screening results.