Down's Syndrome Scotland - Learning Resources

People with Down’s Syndrome are at risk of developing cervical spine problems which can result in chronic or acute neurological problems.

Atlanto-Axial Instability

Down's Syndrome is associated with a defective production of collagen therefore ligaments which normally hold the joints stable can be very slack (ligamentous laxity). This allows an unusually wide range of movement at some joints and can affect the stability of one of the joints in the neck - the atlanto-axial joint.

This joint is the highest joint in the spinal column just at the base of the skull. In addition to slack ligaments the actual bones of the atlanto-axial joint may be poorly developed. These differences could make the joint more likely to dislocate, increased risk of premature degeneration and osteoarthritis in people with Down's Syndrome.

    Key Point

    Atlanto-axial instability can lead to compression of the cervical spinal cord and significant acute or chronic neurological consequences.

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    Key Point

    The possibility atlanto- axial instability must be assessed before any procedures requiring a general anaesthetic.


    Quick Quiz

    Which is a sign of cord compression?

    Neck pain
    Abnormal head posture
    Reduced neck movement
    All of the above

    Where is your Altanto-axial joint?