ATLANTOAXIAL INSTABILITY IN DOWN-SYNDROME - WHICH SCREENING

In this study, we determined the prevalence of Atlanto-Axial Instability (IAA) in a series of 67 patients with Down syndrome, admitted to our Institution. Each patient was evaluated by means of both cervical spine roentgenogram and repetitive neurological examinations. Our observed frequency (5.1%), and that of recent literature (5.4-6.8%) is lower than what was previously reported (10-20%). Radiologic screening is probably not as useful as many Authors believe. We think that repetitive neurological evaluations would be a more appropriate approach to this problem. X-ray examination should be limited to those children with clinical symptoms suggestive of Atlanto-Axial Instability (IAA) or those who are at risk for vertebral dislocation.