Craniocervical Instability in Down Syndrome
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Original Editor - Beth Potter|Catherine Stanislas|Emily Westwood
Top Contributors - Beth Potter, Angeliki Chorti, Cindy John-Chu, Carina Therese Magtibay, Kim Jackson, Laura Beaman, Naomi O'Reilly and Rucha Gadgil
Introduction[edit | edit source]
Down Syndrome, also known as Trisomy 21, is a condition caused by the presence of an extra chromosome (chromosome 21) which results in atypical physical and cognitive development. Down Syndrome occurs in approximately every 1 in 700 births.[1] Within this population Occipito-axial instability effects approximately [X]%, whilst Atlanto-axial instability effects between 20-30%[2].
Clinically Relevant Anatomy[edit | edit source]
Bones: Occiput (inferior aspect of the skull), Atlas (C1), Axis (C2), C3-C7
Joints: Atlanto-occipital (C0/C1) & Atlanto-axial (C1/C2)
Ligaments:Apical, Alar, Transverse Occipital, Transverse, Accessory Atlanto-axial, Nuchal, Intertransverse, Supraspinous, Interspinous, Anterior Longitudinal, Posterior Longitudinal
Muscles: Longus Capitis, Rectus Capitis Anterior, Rectus Capitis Lateralis, Longus Colli, Scalenes (anterior, middle, posterior), Splenius Capitis, Splenius Cervicis, Upper Trapezius, Levator Scapulae
[ADD DIAGRAM/PICTURE]
Overview of Pathology[edit | edit source]
Occipito-axial Instability in Down Syndrome[edit | edit source]
Atlanto-axial Instability in Down Syndrome[edit | edit source]
Epidemiology[edit | edit source]
Signs & Symptoms[edit | edit source]
Differential Diagnoses[edit | edit source]
Screening[edit | edit source]
Atlanto-occipital instability - lateral radiographic imaging using the Rule of 12 or Harris measurement[3].
Atlanto-axial instability - lateral radiographic imaging
Outcome Measures[edit | edit source]
Examination[edit | edit source]
https://www.youtube.com/watch?v=pj-8cAkFYiA
https://www.youtube.com/watch?v=9mbXER7QtNM
Management[edit | edit source]
Surgical
Conservative
Guidelines for Sport[edit | edit source]
Official Recommendations
Contraindications
Exercise for Mental Health
Resources[edit | edit source]
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References[edit | edit source]
- ↑ Mai, C. T., Isenburg, J. L., Canfield, M. A., Meyer, R. E., Correa, A., Alverson, C. J., Lupo, P. J., Riehle-Colarusso, T., Cho, S. J., Aggarwal, D., Kirby, R. S., National Birth Defects Prevention Network, (2019). National population-based estimates for major birth defects, 2010-2014. Birth defects research, 111(18), pp.1420–1435.
- ↑ Nakamura, N., Inaba, Y., Aota, Y., Oba, M., Machida, J., N. Aida, Kurosawa, K., Saito, T, (2016). New radiological parameters for the assessment of atlantoaxial instability in children with Down syndrome. The Bone & Joint Journal, 98-B(12), pp.1704-1710.
- ↑ El-Khouri, M., Mourão, M., Tobo, A., Battistella, L., Herrero, C., Riberto, M, (2014). Prevalence of Atlanto-Occipital and Atlantoaxial Instability in Adults with Down Syndrome. World Neurosurgery, 82(1-2), pp.215-218.
