People with Down’s Syndrome are at risk of developing cervical spine problems which can result in chronic or acute neurological problems.
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.
- Neck pain
- Abnormal head posture
- Torticollis (cricked or wry neck)
- Reduced neck movements
- Deterioration of gait (walk) and/or frequent falls
- Increasing fatigability (tiredness) on walking
- Deterioration of manipulative skills (hand/body movement)
- Perform physical and neurological examination
- Cervical spine x-ray
Atlanto-axial instability can lead to compression of the cervical spinal cord and significant acute or chronic neurological consequences.
Warning Signs of Cord Compression ...
If any of the warning symptoms are evident then urgent medical examination is required:
The possibility atlanto- axial instability must be assessed before any procedures requiring a general anaesthetic.
Which is a sign of cord compression?
Abnormal head posture
Reduced neck movement
All of the above
Where is your Altanto-axial joint?