title: Atlanto-axial instability in adults with Down's syndrome--a survey of a long-stay hospital population.
abstract: A survey was performed on the patients with Down's syndrome living in three long-stay hospitals for the mentally handicapped in Bristol. Each patient had a chromosomal analysis, lateral X-rays of the cervical spine in flexion and extension and subsequent measurement of the atlanto-odontoid distance, and a neurological examination. Out of a total of 59 patients, with ages ranging from 23 to 65 years (average age 48.27 years), three (5%) were found to be in the high risk category radiologically, but of these two were in the medium risk group on neurological examination and one low risk. Of five (8.5%) patients in the medium risk group on X-ray, four were in the medium risk group neurologically. Therefore a total of eight patients (13.6%) could be considered to be at risk of atlanto-axial instability.
authors.affiliation: Stoke Park Hospital, Stapleton, Bristol.
authors.forename: L B
authors.initials: LB
authors.lastname: Cooke
authors.forename: R
authors.initials: R
authors.lastname: Lansdall-Welfare
mesh_terms: D000328:Adult; D000368:Aged; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging; D004314:Down Syndrome / Q000150:complications*; D004739:England; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000453:epidemiology*; D007902:Length of Stay; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011859:Radiography