DOWN'S SYNDROME CERVICAL SPINE INSTABILITY. Key Points.

Key points (Based on DSMIG guidelines for basic essential medical surveillance)

People with Down's syndrome have a small risk for major neurological damage caused by cervical spine instability.

Cervical spine X-Rays have no predictive validity for subsequent acute dislocation/subluxation at the atlantoaxial joint.
Children with Down's syndrome should not be barred from taking part in sporting activities.
Anaesthetists should be alerted to the possibility of cervical spine injury whilst manipulating the head and neck in the unconscious patient.
Ambulance personnel should be alerted to the possibility of cervical spine injury when attending at Road Traffic Accidents.
Clinical symptoms - often mild - are currently the most useful predictors of future risk and merit urgent specialist referral.