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Comment
. 2021 Apr;37(4):1041-1043.
doi: 10.1007/s00381-020-04886-y. Epub 2020 Sep 17.

Letter to the editor regarding "Atlantoaxial dislocation due to os odontoideum in patients with Down's syndrome: literature review and case reports"

Fraser C Henderson Sr  1   2 , Clair A Francomano  3 , Peter C Rowe  4
Affiliations
Comment

Letter to the editor regarding "Atlantoaxial dislocation due to os odontoideum in patients with Down's syndrome: literature review and case reports"

Fraser C Henderson Sr et al. Childs Nerv Syst. 2021 Apr.
No abstract available

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Conflict of interest statement

On behalf of all authors, the corresponding author confirms there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Lateral cervical spine x-ray demonstrates atlantoaxial instability (AAI) in Down syndrome. In this case, mild flexion of the neck demonstrates a widened atlanto-dental interval (solid bar) between the anterior tubercle of C1 (long arrow) and the odontoid process that exceeds the pathological threshold in the adult of 3 mm. The spinal canal (small arrow) is substantially diminished and results in spinal cord compression
Fig. 2
Fig. 2
The model in the left image demonstrates the rotary subluxation (AAI Fielding type 1) that occurs with the hereditary connective tissue disorders. With the rotation of the C1 ring (large black arrow), the atlanto-dental interval (small solid arrow) remains normal (< 3 mm), but the facet joint (vertical arrow) is subluxed with more than 80% loss of facet overlap, and the angular displacement between C1 and C2 exceeds the pathological threshold of 41 degrees. On the right, the cervical spine CT (axial view through the interface of C1 and C2) shows the loss of facet overlap (vertical white arrow), but normal atlanto-dental interval (black arrow), representing a rotary subluxation, Fielding Type 1
See this image and copyright information in PMC

Comment on

References

    1. Sergeenko O, Dyachkov K, Ryabykh S, et al. Atlantoaxial dislocation due to os odontoideum in patients with Down’s syndrome: literature review and case reports. Childs Nerv Syst. 2020;36:19–26. doi: 10.1007/s00381-019-04401-y. - DOI - PubMed
    1. Henderson FC, Sr, Austin C, Benzel E, et al. Neurological and spinal manifestations of the Ehlers-Danlos syndromes. Am J Med Genet C: Semin Med Genet. 2017;175(1):195–211. doi: 10.1002/ajmg.c.31549. - DOI - PubMed
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    1. Henderson FS, Rosenbaum R, Narayana M et al (2020) Atlanto-axial rotary instability (Fielding type 1): characteristic clinical and radiological findings, and treatment outcomes following alignment, fusion, and stabilization. Neurosurg Rev - PMC - PubMed
    1. Joaquim A, Ghizoni E, Tedeschi H, et al. Radiological evaluation of cervical spine involvement in rheumatoid arthritis. Neurosurg Focus. 2015;38(4):E4. doi: 10.3171/2015.1.FOCUS14664. - DOI - PubMed

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