Skip to main content
SpringerLink
Log in

C2/3 instability: unusual cause of cervical myelopathy in a child with Down syndrome

  • Case Report
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

We report a rare cause of cervical myelopathy (CM) in a 10-year-old Down syndrome (DS) girl. She presented with progressive CM over 1 year affecting her ability to ambulate or feed herself. The myelopathy was secondary to C2/3 instability. Surgical reduction and instrumented fusion have significantly improved her neurological status. This case emphasizes the importance of close follow-up of DS patients for early diagnosis and treatment of cervical spine abnormalities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Davidson MA (2008) Primary care for children and adolescents with Down syndrome. Pediatr Clin North Am 55:1099–1111, xi

    Article  PubMed  Google Scholar 

  2. Ali FE, Al-Bustan MA, Al-Busairi WA, Al-Mulla FA, Esbaita EY (2006) Cervical spine abnormalities associated with Down syndrome. Int Orthop 30:284–289

    Article  PubMed  Google Scholar 

  3. Martel W, Tishler JM (1966) Observations on the spine in mongoloidism. Am J Roentgenol Radium Ther Nucl Med 97:630–638

    PubMed  CAS  Google Scholar 

  4. Menezes AH (1997) Craniovertebral junction anomalies: diagnosis and management. Semin Pediatr Neurol 4:209–223

    Article  PubMed  CAS  Google Scholar 

  5. Pueschel SM, Herndon JH, Gelch MM, Senft KE, Scola FH, Goldberg MJ (1984) Symptomatic atlantoaxial subluxation in persons with Down syndrome. J Pediatr Orthop 4:682–688

    Article  PubMed  CAS  Google Scholar 

  6. American Academy of Pediatrics (2001) Health supervision for children with Down syndrome. Pediatrics 107:442–449

    Article  Google Scholar 

  7. Giblin PE, Micheli LJ (1979) The management of atlanto-axial subluxation with neurologic involvement in Down’s syndrome: a report of two cases and review of the literature. In: Clin Orthop Relat Res., pp 66–71

    Google Scholar 

  8. Rizzolo S, Lemos MJ, Mason DE (1995) Posterior spinal arthrodesis for atlantoaxial instability in Down syndrome. J Pediatr Orthop 15:543–548

    Article  PubMed  CAS  Google Scholar 

  9. Tangerud A, Hestnes A, Sand T, Sunndalsfoll S (1990) Degenerative changes in the cervical spine in Down’s syndrome. J Ment Defic Res 34(Pt 2):179–185

    PubMed  Google Scholar 

  10. Yamada H, Yamanaka T (1987) Atlanto-axial and occipito-atlantal dislocation in Down’s syndrome. No to Hattatsu 19:309–314 [Article in Japanese]

    PubMed  CAS  Google Scholar 

  11. Martin GM (1982) Syndromes of accelerated aging. Natl Cancer Inst Monogr 60:241–247

    PubMed  CAS  Google Scholar 

  12. Citow JS, Munshi I, Chang-Stroman T, Sullivan C, Frim DM (1998) C2/3 instability in a child with Down’s syndrome. Case report and discussion. Pediatr Neurosurg 28:143–146

    Article  PubMed  CAS  Google Scholar 

  13. Bosma GP, van Buchem MA, Voormolen JH, van Biezen FC, Brouwer OF (1999) Cervical spondylarthrotic myelopathy with early onset in Down’s syndrome: five cases and a review of the literature. J Intellect Disabil Res 43(Pt 4):283–288

    Article  PubMed  Google Scholar 

  14. Hankinson TC, Anderson RC (2010) Craniovertebral junction abnormalities in Down syndrome. Neurosurgery 66:32–38

    Article  PubMed  Google Scholar 

  15. Wexler ID, Abu-Libdeh A, Kastiel Y, Nimrodi A, Kerem E, Tenenbaum A (2009) Optimizing health care for individuals with Down syndrome in Israel. Isr Med Assoc J 11:655–659

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, PO Box 59220, Riyadh, 11525, Saudi Arabia

    Amro Al-Habib & Ahmed AlAqeel

Authors
  1. Amro Al-Habib
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmed AlAqeel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amro Al-Habib.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Al-Habib, A., AlAqeel, A. C2/3 instability: unusual cause of cervical myelopathy in a child with Down syndrome. Childs Nerv Syst 29, 163–165 (2013). https://doi.org/10.1007/s00381-012-1950-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-012-1950-2

Keywords

Search

Navigation