PREVALENCE OF ATLANTO-AXIAL INSTABILITY AND ITS ASSOCIATION WITH CLINICAL SIGNS IN CHILDREN WITH DOWN SYNDROME

  • Érica Cesário Defilipo Departamento de Fisioterapia, Universidade Federal de Juiz de Fora (UFJF) - Campus Governador Valadares - Governador Valadares (MG), Brasil.
  • Priscila Cristian do Amaral Faculdade de Fisioterapia, UFJF - Juiz de Fora (MG), Brasil
  • Natália Trindade de Souza Faculdade de Fisioterapia, UFJF - Juiz de Fora (MG), Brasil
  • Carla Trevisan Martins Ribeiro Instituto Nacional da Saúde da Mulher, da Criança e do Adolescente, Fernandes Figueiras (IFF/FIOCRUZ) - Rio de Janeiro (RJ), Brasil
  • Paula Silva de Carvalho Chagas Departamento de Fisioterapia do Idoso, do Adulto e Materno-infantil, Faculdade de Fisioterapia, UFJF - Juiz de Fora (MG), Brasil
  • Flávio Augusto Teixeira Ronzani Departamento de Clínica Médica da Faculdade de Medicina, UFJF - Juiz de Fora (MG), Brasil

Resumo

Introduction: A change in the atlanto-axial alignment in children with Down syndrome may be associated with pain, neurological disorders, high spinal cord compression and sudden death. Objective: To determine the prevalence of atlanto-axial instability in children with Down syndrome and its association with the presence of signs and symptoms of atlanto-axial instability. Methods: A cross-sectional study evaluated 21 children with Down syndrome aged between 3 and 5 years. Children who had undergone cervical spine surgery or who had diseases not associated with this syndrome were excluded. Sex, age, ethnicity of the child and the presence of signs suggestive of atlanto-axial instability, as reported by caregivers, such as neck pain, difficulty walking, weakness in the lower limbs, fatigue, difficulty with balance, urinary and fecal incontinence and projectile vomiting were studied. Children underwent a cervical spine X-ray in the lateral view in three positions: neutral, flexion and extension. When the atlas-odontoid distance was equal to or greater than 4.5 mm, atlanto-axial instability was diagnosed. Results: The prevalence of atlanto-axial instability in the studied population was 9.5%. There was no significant association revealed in the chi-square test between the signs suggestive of atlanto-axial instability and the presence of atlanto-axial instability (p > 0.05). Conclusions: Atlanto-axial instability is possibly not associated with its suggestive signs.

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Publicado
2015-10-20
Seção
Pesquisa Original