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Cervical spine abnormalities in institutionalized adults with Down's syndrome
R A MacLachlan1, K E Fidler, H Yeh
1Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
Journal of Intellectual Disability Research : JIDR
|June 1, 1993
Summary
Adults with Down's syndrome (DS) have a higher prevalence of increased anterior atlanto-odontoid distance (AAOD) and cervical spine degeneration. While DS individuals face theoretical risks, clinical significance appears minimal and decreases with age.
Area of Science:
- Orthopedics
- Neurology
- Genetics
Background:
- Down's syndrome (DS) is associated with increased risk of certain medical conditions.
- Cervical spine abnormalities, including increased anterior atlanto-odontoid distance (AAOD) and degenerative disease (DDCS), are potential concerns in adults with DS.
Purpose of the Study:
- To determine and compare the prevalence of increased AAOD and DDCS in institutionalized adults with DS versus age- and sex-matched controls.
- To assess the clinical significance and age-related trends of these cervical spine conditions in DS.
Main Methods:
- Radiographic comparison of cervical spines in 99 adults with DS and 198 controls.
- Standardized rating scale used to evaluate AAOD and DDCS.
- Statistical analysis to compare prevalence and severity between groups.
Main Results:
- Higher prevalence of AAOD (≥3 mm) in DS cases (8%) vs. controls (2%) (P < 0.01).
- Greater mean AAOD in DS cases (2.0 mm) vs. controls (1.5 mm) (P < 0.01).
- Significantly higher prevalence and severity of DDCS in DS cases (64% any degree, 45% moderate/severe) vs. controls (39% any degree, 12% moderate/severe) (P < 0.001).
Conclusions:
- Adults with DS exhibit increased AAOD and DDCS compared to controls.
- Despite theoretical risks for spinal cord compression from increased AAOD, clinical significance appears low and diminishes with age in the DS population.
- DDCS is more prevalent and severe in DS individuals across all age groups.