title: Comparison of neurologic deficits with atlanto-dens intervals in patients with Down syndrome.
abstract: Eighty-four patients with Down syndrome had flexion-extension lateral roentgenograms of the C1-C2 articulation for the purpose of dividing the group into subluxators (> or = 4 mm atlanto-dens interval and 2 mm translation) and nonsubluxators (those who did not meet these criteria). Neurologic examinations and chart review were carried out on all patients to ascertain those with a positive neurologic finding or history. Seventeen (20%) were defined as subluxators and 67 (80%) as nonsubluxators. Five (29%) of the subluxators were found to have positive neurologic findings and 18 (27%) of the nonsubluxators had similar types of positive neurologic findings. These percentages are not significantly different. This led us to conclude that positive neurologic findings and an abnormal atlanto-dens interval are not alone adequate criteria to judge need for surgical stabilization of the C1-C2 articulation in patients with Down syndrome.
authors.affiliation: Shriners Hospitals for Children, Spokane, Washington 29210, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Ferguson
authors.forename: M E
authors.initials: ME
authors.lastname: Putney
authors.forename: B L
authors.initials: BL
authors.lastname: Allen
mesh_terms: D000293:Adolescent; D000328:Adult; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D004314:Down Syndrome / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D004204:Joint Dislocations / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D007593:Joint Instability / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011859:Radiography; D012021:Reflex, Abnormal; D013117:Spinal Cord Compression / Q000209:etiology* / Q000473:pathology