Observations on the Spine in Mongoloidism

Martel, William; Tishler, Jack M.

doi:10.2214/ajr.97.3.630

Cited by 84 publications

(42 citation statements)

References 2 publications

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“…The occurrence of degenerative changes in the cervical spine of patients with DS was first reported in 1966 [11]. As expected, these changes increase with age [7,10,11], but they occur earlier than in the normal population [10,14].…”

Section: Introductionmentioning

confidence: 79%

“…We studied a group of patients 15 years and older, who were predominantly young adults. We followed the example of many studies on AAI in considering adults to be those ≥15 years of age [3,6,10,11]. Otherwise, our sample was mixed containing both sexes living in an institution or in the community.…”

Section: Discussionmentioning

confidence: 99%

“…As expected, these changes increase with age [7,10,11], but they occur earlier than in the normal population [10,14]. Although cervical spondylosis has the potential to cause cervical cord damage [14], it has received less attention in the literature than AAI.…”

Section: Introductionmentioning

confidence: 92%

“…The association was first reported in 1961 [23], almost 100 years after DS was described. Although numerous reports followed [11,17,21], AAI came into the limelight only in 1983 when the Special Olympics prohibited DS individuals having the condition from participating in certain neck-stressing sports [22]. AAI, which affects 10-20% of individuals with DS, is mostly asymptomatic and is diagnosed using radiography [1,4,11,12].…”

Section: Introductionmentioning

confidence: 99%

“…1). The upper limit of a normal AAOD is 4 mm in subjects who are younger than 15 years and 3 mm in older subjects [3,10,11,19]. The anterior space between the atlas and the axis normally opens in flexion and closes in extension, which is why the AAOD is greater when the neck is radiographed in flexion than it is in neutral or extension positions [16].…”

Section: Introductionmentioning

confidence: 99%

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Cervical spine abnormalities associated with Down syndrome

Ali

Al-Bustan

Al-Busairi

et al. 2006

International Orthopaedics (SICO

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Atlantoaxial instability (AAI) affects 10-20% of individuals with Down syndrome (DS). The condition is mostly asymptomatic and diagnosed on radiography by an enlarged anterior atlanto-odontoid distance. Symptomatic AAI, which affects 1-2% of individuals with DS, manifests with spinal cord compression. Cervical spondylosis, which is common in DS, also has the potential for cord damage but it has received less attention because paediatric populations were mostly studied. Forty-four Kuwaiti subjects with DS, whose ages were ≥15 years, were evaluated clinically and radiographically. Lateral neck radiographs were taken in the neutral and flexion positions. Asymptomatic AAI was diagnosed in eight subjects (18%) and congenital anomalies of C1-2 were found in five (12%). Five patients had AAI in flexion only while three patients had it in both views. Three patients with AAI had odontoid anomalies contributing to the condition. When assessing AAI, the posterior atlanto-odontoid distance has to be considered because it indicates the space available for the cord. Cervical spondylosis was noted in 16 (36%) subjects. Degenerative changes increased with age, occurred earlier than in the normal population, and affected mostly the lower cervical levels. Half the patients with AAI had cervical spondylosis, a comorbidity that puts the cord at increased risk.Résumé L'instabilité de la charnière occipito atloïdienne affecte 10 à 20% des sujets présentant un Down syndrome (trisomie 21). Cette instabilité est souvent asymptomatique et seulement diagnostiquée sur les radiographies qui montrent un élargissement de la distance antérieure atloïdo-odontoide. L'asymptologie de l'instabilité occipito atloïdienne affecte 1 à 2% des sujets présentant un Down syndrome avec des signes manifestes de compression médullaire. La spondylose cervicale qui est habituelle dans le Down syndrome peut potentialiser des lésions de la moelle. 44 sujets Koweitis présentant un Down syndrome dont l'âge était supérieur à 15 ans ont été évalués cliniquement et radiographiquement. Des radiographies de la colonne cervicale de profil ont été effectuées en position neutre et en position de flexion. Une instabilité occipito atloïdienne a été diagnostiquée chez 8 sujets (18%) avec des anomalies congénitales de C1 C2, chez 5 sujets (12%). 5 patients présentaient une instabilité uniquement en flexion et 3 patients présentaient une telle instabilité sur tous les clichés. 3 patients avec une instabilité occipito atloïdienne présentaient des anomalies de l'odontoide aggravant encore les conditions locales. Lorsqu'il existe une instabilité occipito atloïdienne, la distance C1 odontoide doit être évaluée car elle indique l'espace possible pour la moelle. Une spondylolyse cervicale a été relevée chez 16 patients (36% des sujets). Avec l'âge, les lésions dégénératives peuvent évoluer, survenant plus tôt que dans la population normale et peuvent léser les différents niveaux de la colonne cervicale. La moitié des patients avec une instabilité occipito atloïdienne ont un...

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