Spinal Deformity in Down Syndrome

Publication date: Available online 23 August 2012Source: Spine DeformityAuthor(s): John R. Dimar, Leah Y. CarreonAbstractDown syndrome is a common genetic disorder that has a significant incidence of spinal pathology. The most common spinal disorder is ligamentous laxity of the cervical spine that involves either the occiput-C1 level, which causes atlanto-occipital instability (AOI), or the C1-C2 level, which causes atlanto-axial (AAI) instability. These areas of cervical instability warrant close monitoring for progressive instability or neurological changes that may require restriction from sports or, in certain cases, surgical stabilization. Down syndrome patients also require close monitoring as they age, because they may also develop acquired degenerative changes in the cervical spine that may result in myelopathy. Scoliosis may also develop in Down syndrome patients; the incidence is unknown. However, certain thoracic curves are also known to occur after an early thoracotomy for heart disease. Spondylolisthesis may also occur and present with the classic symptoms of low back pain and radiculopathy. The current recommended treatments for both of these conditions are identical to those for normal children. Surgery should be approached with caution and only after competent medical clearance, because surgery is associated with high complication rates: most notably infection, pseudarthrosis, instrumentation loosening, respiratory arrest, and death.
Source: Spine Deformity - Category: Orthopaedics Source Type: research