Prevalence of atlanto-occipital and atlantoaxial instability in adults with Down syndrome.
OBJECTIVE
This study sought to evaluate the presence of atlanto-occipital and atlantoaxial instabilities as well as their clinical significance in patients with Down syndrome.


METHODS
The present study retrospectively evaluated 80 adults with Down syndrome for the presence of atlanto-occipital and atlantoaxial instability in lateral craniocervical radiographic images. Atlanto-occipital instability was defined by the Rules of 12 or Harris measurements, using the values of the basion-dens interval or the basion-axial interval. Atlantoaxial instability was radiologically identified by the space between the anterior border of the odontoid apophysis and the posterior border of the atlas arch, as well as by the Wiesel-Rothman line.


RESULTS
Eighty patients were assessed; 14 (17.5%) presented with atlanto-occipital instability and 9 (11.2%) with atlantoaxial instability. Only 3 patients (3.8%) had specific symptoms for cervical instability. There was no statistical correlation with patient age or gender.


CONCLUSIONS
High cervical instability in patients with Down syndrome can also be observed among adults, and there is a low correlation between the radiological findings and symptoms. These findings emphasize the importance of periodic follow-up on these patients, particularly when sports activities are considered.
['El-Khouri|Marcelo|M|', 'Mourão|Marcelo Alves|MA|', 'Tobo|Andrea|A|', 'Battistella|Linamara Rizzo|LR|', 'Herrero|Carlos Fernando Pereira|CF|', 'Riberto|Marcelo|M|']
D000328:Adult D001268:Atlanto-Axial Joint D001269:Atlanto-Occipital Joint D001938:Brazil D003430:Cross-Sectional Studies D004314:Down Syndrome D005260:Female D006801:Humans D007593:Joint Instability D008297:Male D015995:Prevalence D011859:Radiography D013177:Sports D011795:Surveys and Questionnaires D055815:Young Adult
Prevalence Atlantoaxial instability Adult Down syndrome Atlanto-occipital instability