152 results match your criteria: "Atlantoaxial Instability in Individuals with Down Syndrome"

Article Synopsis
  • - Duchenne muscular dystrophy (DMD) is an X-linked genetic disorder primarily causing progressive muscle weakness, treated mainly with glucocorticoids and physical therapy.
  • - Joint hypermobility can occur alone or in connection with conditions like Ehlers-Danlos syndrome, which may lead to cardiovascular issues, while osteogenesis imperfecta involves fragile bones prone to fractures.
  • - Down syndrome (trisomy 21) is the most common chromosomal abnormality, and while routine imaging for atlantoaxial instability isn't recommended in asymptomatic children, careful evaluation is necessary for sports participation; achondroplasia, resulting in disproportionate short stature and other skeletal features, requires education for safe handling.
View Article and Find Full Text PDF

Purpose: Surgical stabilization of the Atlas vertebrae is indicated for severe atlantoaxial instability (AAI) in patients with Down syndrome (DS). This study aims to evaluate the morphological characteristics of the Atlas lateral mass (ALM) in patients with DS with regard to safe instrumentation for surgical stabilization and to compare them with non-syndromic group.

Methods: This multicenter, retrospective, case-control study included age- and sex-matched patients with and without DS aged > 7 years with a cervical computed tomography (CT) scan.

View Article and Find Full Text PDF

In this article, we describe a rare and complex case of moyamoya syndrome in a 7-year-old boy with Down syndrome and atlantoaxial subluxation. The patient presented with an ischemic stroke in the left hemisphere and cervical cord compression with increased cord edema. Diagnostic digital subtraction angiography revealed unique patterns of vascular involvement, with retrograde flow through the anterior spinal artery, ascending cervical artery, occipital artery, and multiple leptomeningeal arteries compensating for bilateral vertebral artery occlusion.

View Article and Find Full Text PDF

Objectives: Children with trisomy 21 often have anatomic and physiologic features that may complicate tracheal intubation (TI). TI in critically ill children with trisomy 21 is not well described. We hypothesize that in children with trisomy 21, TI is associated with greater odds of adverse airway outcomes (AAOs), including TI-associated events (TIAEs), and peri-intubation hypoxemia (defined as > 20% decrease in pulse oximetry saturation [Sp o2 ]).

View Article and Find Full Text PDF

Objective: Down syndrome (DS) affects 1 in 700 live births and approximately one-third of patients develop craniovertebral junction (CVJ) instability, diagnosed by clinical examination and radiological measures such as the atlantodens interval (ADI) and space available for the cord (SAC). Patients with symptomatic CVJ instability are at increased risk for spinal cord injury. There are no guidelines for surgical management of CVJ instability in DS, the existing literature is sparse, and there is a lack of consistent pediatric data.

View Article and Find Full Text PDF

Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 century.

Dis Mon

August 2023

Professor, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, United States; Associate Dean, Health Equity and Community Affairs, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.

Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.

View Article and Find Full Text PDF

Cranial-Vertebral-Maxillary Morphological Integration in Down Syndrome.

Biology (Basel)

March 2022

Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.

Background: Morphological integration refers to the tendency of anatomical structures to show correlated variations because they develop in response to shared developmental processes or function in concert with other structures. The objective of this study was to determine the relationships between the dimensions of different cranial-cervical-facial structures in patients with Down syndrome (DS). Methodology: The study group consisted of 41 individuals with DS who had undergone cone-beam computed tomography (CBCT) at the Dental Radiology Unit of the University of Santiago de Compostela (Spain).

View Article and Find Full Text PDF

Purpose: Rigid occipitocervical (O-C) instrumentation can reduce the anterior pathology and has a high fusion rate in children with craniovertebral instability. Typically, axis (C2) screw fixation utilizes C1-C2 transarticular screws or C2 pars screws. However, anatomic variation may preclude these screw types due to the size of fixation elements or by placing the vertebral artery at risk for injury.

View Article and Find Full Text PDF

Down Syndrome-Associated Arthritis (DA): Diagnostic and Management Challenges.

Pediatric Health Med Ther

March 2022

Division of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.

Down syndrome (DS) is one of the most common birth defects in the United States, the most common genomic disorder of intellectual disability, and results from trisomy 21. This chromosome disorder causes an extensive, heterogenous phenotype that results in a broad presentation of symptoms that includes atlantoaxial instability, congenital heart defects, muscle hypotonia, hypothyroidism, hematologic disorders, recurrent infections, and autoimmune diseases. The autoimmune diseases are caused by immune system dysregulation that results in increased pro-inflammatory cytokines, along with other innate and adaptive immune system dysregulation.

View Article and Find Full Text PDF

Background: Pediatric atlantoaxial instability (AAI) is not common and could be a serious clinical condition. The Goel-Harms technique is one of the most used techniques in adults and needs more evaluation in pediatric populations. This study reports the feasibility and safety of the Goel-Harms technique in the treatment of pediatric reducible AAI.

View Article and Find Full Text PDF

Background: Atlantoaxial instability (AAI) is common in pediatric patients with Trisomy 21 and can lead to spinal cord injury during sports, trauma, or anesthetized neck manipulation. Children with Trisomy 21 therefore commonly undergo radiographic cervical spine screening, but recommendations on age and timing vary. The purpose of this study was to determine if instability develops over time.

View Article and Find Full Text PDF

Background: The proclivity to atlantoaxial instability (AAI) has been widely reported for conditions such as rheumatoid arthritis and Down syndrome. Similarly, we have found a higher than expected incidence of AAI in hereditary connective tissue disorders. We demonstrate a strong association of AAI with manifestations of dysautonomia, in particular syncope and lightheadedness, and make preliminary observations as to the salutary effect of surgical stabilization of the atlantoaxial motion segment.

View Article and Find Full Text PDF

Importance: Down syndrome is the most common chromosomal condition, and average life expectancy has increased substantially, from 25 years in 1983 to 60 years in 2020. Despite the unique clinical comorbidities among adults with Down syndrome, there are no clinical guidelines for the care of these patients.

Objective: To develop an evidence-based clinical practice guideline for adults with Down syndrome.

View Article and Find Full Text PDF

Purpose: The fusion of the upper cervical spine in children is demanding due to its reduced size, its anatomical complexity, or a severe pathology of the cranio-cervical junction. In some pediatric patients with today's more popular C1-C2 or, occipito-C2 techniques, it is impossible, or very risky to perform a short upper cervical fixation.

Methods: We present the utility and good results of ipsilateral laminar C2 screws insertion technique in two pediatric cases with low C2 laminar profile.

View Article and Find Full Text PDF

Evaluation of 2011 AAP cervical spine screening guidelines for children with Down Syndrome.

Childs Nerv Syst

November 2020

Department of Pediatric Neurosurgery, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave, PO Box 330, Aurora, CO, 80045, USA.

Purpose: Atlantoaxial instability (AAI) has a higher incidence rate among individuals with Down syndrome (DS) than the non-DS population. In 2011, the American Academy of Pediatrics (AAP) updated its AAI screening guidelines for children with DS from radiographic screening to radiographs only if there are clinical symptoms suggestive of cervical spine pathology. An assessment of whether this alteration has been associated with an increase in AAI-associated spinal cord injury has not been undertaken.

View Article and Find Full Text PDF

Rare Presentation: A Report of 2 Identical Cases with Thoracic Compressive Myelopathy in Down Syndrome.

World Neurosurg

October 2020

Department of Neurosurgery, Institute of Neurosciences, Medanta-The Medicity Hospital, Gurgaon, Haryana, India. Electronic address:

Background: Atlantoaxial instability, a common finding in patients with Down syndrome (DS), is attributed to laxity of ligamentous structures. Cervical spondylosis identified in these patients has a pathogenesis of ligament laxity and early degeneration compared with the normal population. No cases have been reported showing affection of thoracic or lower levels.

View Article and Find Full Text PDF

Purpose: To clarify etiology, clinical features, and diagnostic and treatment options of atlantoaxial dislocation (AAD) due to os odontoideum (OsO) in patients with Down's syndrome (DS).

Methods: We described and analyzed three clinical cases of AAD due to OsO in DS patients and reviewed descriptions of similar cases in the scientific sources.

Results: According to literature review, more than 80% of DS patients with odontoid ossicles had atlantoaxial instability (AAI).

View Article and Find Full Text PDF

Extraforaminal Vertebral Artery Until C2 Transverse Foramen in Down Syndrome Patient Affected by Atlantoaxial Subluxation: First Observation and Review of Literature.

World Neurosurg

November 2019

Craniovertebral Junction Operative Unit and Master CVJ Surgical Approach Research Center, Institute of Neurosurgery, Fondazione Policlinico "A. Gemelli, " Catholic University, Largo F. Vito, Rome, Italy.

Background: Patients with Down syndrome (DS) have an increased incidence of multisystem disorders, like cardiovascular, neurologic, gastrointestinal, respiratory, and musculoskeletal disorders. Craniovertebral junction instability is a common illness in DS patients, and they may often be affected by vertebral artery (VA) anomalies.

Case Description: In this paper we present neuroradiologic findings of a 34-year-old female patient affected by DS with atlantoaxial subluxation, scheduled for transoral decompression of C1-C2 and posterior occipitocervical fixation.

View Article and Find Full Text PDF

Spontaneous atlanto-axial dislocation and trisomy 21: causal factors and management.

Pan Afr Med J

July 2019

Department of Neurosurgery, Mohammed VI Hospital, Cadi Ayyad University, Marrakesh, Morocco.

Spontaneous atlanto-axial (C1-C2) dislocation is an atlanto-axial instability, found in 10 to 30% of trisomy 21 patients, the majority of whom is asymptomatic. We report a case of a 21 years-old woman, with trisomy 21, admitted in our department presenting a spinal cord compression syndrome with right hemiparesis associated with a cervicalgia evolving for 3 months of admission without trauma. Standard cervical radiography showed a C1-C2 dislocation with posterior displacement of the odontoid process.

View Article and Find Full Text PDF

Background/aims: Down syndrome is the most common inherited disorder. Some patients develop atlantoaxial instability. Existing screening guidelines were developed prior to availability of MRI.

View Article and Find Full Text PDF

Iatrogenic neurological injury in children with trisomy 21.

Int J Pediatr Otorhinolaryngol

November 2018

Department of Otolaryngology, Hospital for Sick Children, Toronto, ON, Canada; Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address:

Purpose: Children with trisomy 21 are at a greater risk for craniocervical junction instability than the general population. These children frequently require administration of anesthesia due to surgical (including otolaryngological) interventions and are at risk for neurological injury. We reviewed the current literature describing iatrogenic neurological injury in children with trisomy 21 undergoing anesthesia in order to facilitate the development of safety recommendations.

View Article and Find Full Text PDF

Cervical instability in patients with Trisomy 21: The eternal gamble.

Paediatr Anaesth

October 2018

Department of Anesthesia, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.

Patients with Trisomy 21 are particularly at risk of cervical instability due to ligamentous laxity and osseous abnormalities. Up to 30% of Trisomy 21 patients are affected by atlanto-axial or atlanto-occipital instability, but only 1%-2% of cases are symptomatic. The radiologic assessment of cervical instability is not unanimously considered mandatory.

View Article and Find Full Text PDF

The American Academy of Pediatrics's guideline on health supervision for children with Down syndrome (DS) offers pediatricians guidance to improve detection of comorbid conditions. Pediatrician adherence has not yet been comprehensively evaluated. Medical records of 31 children with DS who received primary care at two urban academic clinic sites from 2008-2012 were reviewed.

View Article and Find Full Text PDF

Down syndrome (DS) is a clinical syndrome comprising typical facial features and various physical and intellectual disabilities due to extra genetic material on chromosome 21, with one in every 1000 babies born in the United Kingdom affected. Patients with Down syndrome are at risk of atlantoaxial instability (AAI). Although AAI can occur in other conditions, such as rheumatoid arthritis, this position statement deals specifically with patients with DS and asymptomatic AAI.

View Article and Find Full Text PDF