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Spine instability and the special olympics

M J Goldberg1

  • 1Department of Orthopaedic Surgery, Tufts University School of Medicine, Boston, Massachusetts.

Clinics in Sports Medicine
|July 1, 1993
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People with Down syndrome often have upper cervical spine abnormalities, most commonly an increased atlanto-dens interval. While often asymptomatic, the long-term outcomes are unknown, guiding treatment by clinical factors.

Area of Science:

  • Orthopedics
  • Genetics
  • Pediatrics

Background:

  • Down syndrome is associated with various upper cervical spine abnormalities.
  • An increased atlanto-dens interval is a well-recognized finding in this population.
  • Most individuals with these abnormalities remain asymptomatic.

Purpose of the Study:

  • To review the spectrum of upper cervical spine abnormalities in Down syndrome.
  • To discuss the clinical implications and management of these findings.
  • To highlight the lack of established natural history data for guiding treatment decisions.

Main Methods:

  • Literature review of studies on cervical spine abnormalities in Down syndrome.
  • Analysis of clinical determinants influencing treatment recommendations.

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  • Synthesis of current understanding regarding asymptomatic presentations.

    • Main Results:

    • A wide range of upper cervical spine abnormalities exist in Down syndrome.
    • Increased atlanto-dens interval is the most prevalent abnormality.
    • Current treatment strategies rely on clinical assessment due to unknown natural history.

    Conclusions:

    • Upper cervical spine abnormalities are common in Down syndrome, with atlanto-dens interval being most frequent.
    • Asymptomatic presentation is typical, but long-term outcomes require further investigation.
    • Clinical judgment remains paramount in managing these patients in the absence of definitive natural history data.