La Francis M E
J Manipulative Physiol Ther. 1990 Mar-Apr;13(3):157-60.
The purpose of this paper is to review the current information on atlantoaxial instability in Down's syndrome. There are potentially fatal consequences to performing adjustive manipulation to the cervical spine of the Down's patient. Atlantoaxial subluxation can cause death. Up to 50% of those suffering from atlantoaxial instability have it due to anomalous axis formation and/or agenesis or laxity of the transverse ligament. Trauma or progressive anterior displacement of atlas may cause serious neurological complications. The standard treatment for atlantoaxial instability is surgical fusion of the upper cervical spine. Conservative chiropractic care is suggested as a possible alternative in some cases. Standards for adjusting patients suffering from Down's syndrome have not been established. However, guidelines reviewed in this paper may indicate when adjusting may be hazardous. Potential protocol for the evaluation and diagnosis of atlantoaxial instability are suggested.
本文旨在回顾目前有关唐氏综合征寰枢椎不稳定的信息。对唐氏综合征患者的颈椎进行调整性手法操作可能会带来潜在的致命后果。寰枢椎半脱位可导致死亡。高达50%的寰枢椎不稳定患者是由于枢椎形成异常和/或横韧带发育不全或松弛所致。外伤或寰椎的渐进性前移可能会导致严重的神经并发症。寰枢椎不稳定的标准治疗方法是上颈椎手术融合。在某些情况下，建议将保守的整脊治疗作为一种可能的替代方法。目前尚未确立针对唐氏综合征患者进行调整的标准。然而，本文所回顾的指南可能会指出何时进行调整可能具有危险性。文中还提出了评估和诊断寰枢椎不稳定的潜在方案。
