Home > Journals > Chirurgia > Past Issues > Chirurgia 2015 February;28(1) > Chirurgia 2015 February;28(1):43-7

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe PROMO
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions
Cite this article as

 

CASE REPORTS   

Chirurgia 2015 February;28(1):43-7

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Non-fixed (mobile) rotational atlantoaxial subluxation in Down Syndrome

Grant R. A., Quon J. L., Diluna M. L.

Department of Neurosurgery, Section of Pediatric Neurosurgery, Yale University School of Medicine, New Haven, CT, USA


PDF


AIM: Craniocervical junction abnormalities are common in children with Down Syndrome secondary to ligamentous laxity or malformation of C1 and C2. Excess mobility of this articulation results in atlantoaxial instability and at an extreme can result in dislocation. We review the presentation, diagnostic work-up and management of rotary atlantoaxial subluxation in a population predisposed to developing this condition.
METHODS: In this report, we describe a six year-old child who was found to have non-fixed rotatory atlantoaxial subluxation presenting with neck discomfort, followed by torticollis, after undergoing general anesthesia for a minor surgical procedure.
RESULTS: Imaging demonstrating that his anteriolisthesis was purely rotary, reducing at neutral, and that the transverse atlantal and alar ligaments were intact. He was treated conservatively with a cervical collar for 6 weeks with complete resolution of his mobile rotatory atlantoaxial subluxation.
CONCLUSION: Conservative management is appropriate for patients who present with rotatory atlantoaxial subluxation and no neurological sequelae. However, should neurological sequelae be present, halo immobilization, and even potentially posterior cervical fixation will likely be warranted to protect the neural elements.

top of page