Down syndrome. Cervical spine abnormalities and problems.

A review of the radiographs of 34 individuals with Down syndrome (DS), between 5 and 21 years of age, demonstrated subluxation of atlantoaxial instability (C1-C2) greater than 5 mm in three of the 34 individuals (9 percent). This is in general agreement with previously reported ranges of 10 to 20 percent. A review of the cervical spine radiographs of adults with DS, between 26 and 42 years of age, showed no subluxation but significant degenerative changes of the cervical spine with spur formation, narrowing of foramina, narrowing of the disc inner space, and osteophyte formation. In both the DS child and the DS adult, the cervical spine may be an area of significant potential problems. In all cases any complaints of cervical pain or historical/clinical findings suggestive of neurologic involvement should initiate evaluation of the cervical spine. Baseline radiographic studies of the cervical spine are indicated in all DS children older than 5 years of age and should be considered in all DS adults, particularly those 30 years of age and older.