CHILDREN WITH DOWN syndrome may have occipitocervical and atlantoaxial instability. To prevent neurologic injury during athletic competitions, such as the Special Olympics, radiographic cervical spine screening was established in 1983 as a prerequisite for participation in some events. This review discusses the biomechanics underlying upper cervical instability in children with Down syndrome, the evolution of cervical spine screening protocols, and current opinion regarding management for children with Down syndrome and upper cervical instability.
Department of Neurosurgery, Columbia University, College of Physicians and Surgeons, Neurological Institute of New York, New York, New York
Reprint requests: Todd C. Hankinson, MD, Department of Neurosurgery, Columbia University, College of Physicians and Surgeons, 710 West 168th Street, NI Box #132, New York, NY 10032. E-mail: firstname.lastname@example.org
Received, March 7, 2009.
Accepted, November 28, 2009.