Roentgenological Study of the Upper Cervical Spine in Children with Down Syndrome

Abstract

One hundred patients with Down syndrome, between one and fifteen years old, were evaluated for instability of the cervical spine at the atlanto-axial joint. Roentgenologically, the odontoid process was considered normal in ninty-seven patients, and abnormal in three patients. The mean atlanto-dens interval in ninty-seven patients with normal odontoid process was 2.5±1.0mm in flexion and 1.2±0.8mm in extension. Six patients (six per cent) exhibited abnormal intervals (4.5mm or more) during flexion. Of these patients, three patients had the slightly ligamentous atlanto-axial joint instability, another three patients who had the atlanto-axial instability with the osseous malformation of the odontoid process showed narrowing of antero-posterior diameter of the atlas and the cervical spinal canal in atlanto-axial level. One patient with abnormal odontoid process had any symptoms and signs of spinal cord compression at examination.