title: [Atlanto-axial instability in children with trisomy 21: atlanto-axial (C1-C2) or occipito-axial (O-C2) arthrodesis?].
abstract: A retrospective study involving seven cases of operated atlantoaxial (C1-C2) instability in patients with Down Syndrome prompted the authors to raise the following question: which kind of arthrodesis is to be performed for these patients? The possibility of an occipito-atlantal (O-C1) instability, is in fact relatively frequent in this condition, as the authors have observed themselves and in a literature survey; this is an argument for performing an occipito-axial (O-C2) arthrodesis. The difficulties met to reduce the C1-C2 luxation, the frequent pseudarthroses (3 cases in our series) and a tetraplegia following a re-operation for non-union are as many other arguments to perform a O-C2 arthrodesis rather than a C1-C2 arthrodesis.
authors.affiliation: Service d'orthopédie Traumatologie Infantile de l'Hôpital des Enfants Malades à Paris.
authors.forename: V
authors.initials: V
authors.lastname: Arlet
authors.forename: P
authors.initials: P
authors.lastname: Rigault
authors.forename: J P
authors.initials: JP
authors.lastname: Padovani
authors.forename: P
authors.initials: P
authors.lastname: Janklevicz
authors.forename: P
authors.initials: P
authors.lastname: Touzet
authors.forename: G
authors.initials: G
authors.lastname: Finidori
mesh_terms: D000293:Adolescent; D001268:Atlanto-Axial Joint; D001269:Atlanto-Occipital Joint; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D011542:Pseudarthrosis / Q000209:etiology; D011782:Quadriplegia / Q000209:etiology; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*
vernacular_title: Instabilité atloïdo-axoïdienne de l'enfant trisomique 21: arthrodèse atloïdo-axoïdienne (C1-C2) ou occipito-axoïdienne (O-C2)?