title: Successful cranio-cervical fusion in a patient with Down syndrome.
abstract: We present a patient with Down syndrome with neck pain and severe cervical myelopathy. Imaging revealed occipito-atlantal and atlanto-axial instability with severe spinal cord compression. There are no standardized radiological or clinical guidelines to aid in managing this unique subset of patients. We demonstrate a successful occiput-C3 internal fixation and fusion without complication. Due to the largely unknown natural history and ongoing management difficulties in this population, we demonstrate a case that may aid future decision making for this specialized field. We also discuss an approach to reduce this deformity, which, to our knowledge, has not been published before.
authors.affiliation: Prince of Wales Hospital, Barker Street, Randwick, Sydney, New South Wales, Australia. cjoh65796@gmp.usyd.edu.au
authors.forename: C S
authors.initials: CS
authors.lastname: Johnson
authors.forename: D N
authors.initials: DN
authors.lastname: Wilson
authors.forename: R J
authors.initials: RJ
authors.lastname: Mobbs
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D004314:Down Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005539:Foramen Magnum / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019547:Neck Pain / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D013117:Spinal Cord Compression / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*