Atlanto-axial instability

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  • Associated with Down Syndrome
  • Laxity in the posterior transverse ligament mobility between C1-C2 cord compression

Presentation

  • Asymptomatic
  • Dizzines, vertigo, diplopia
  • Behavioral changes
  • Incontinence
  • UMN: Babinski, spasticity, DTRs

Diagnosis

  • PE
  • X-rays (flexion, extension, neutral, open-mouth)

Treatment

C1-C2 fusion