• Abdullah Alatar, Amro F Al-Habib, Fahad Albadr, Ahmed Al-Ahmari, Abdulkarim Al Rabie, Fehid Habalrih, Husam Altahan, Sami Aleissa, Fawaz Almotairi, Abdulwahed Barnawi, Moutasem Azzubi, Abdullah Abu Jamea, and Essam AlShail.
• Department of Surgery, College of Medicine, King Saud University, PO Box: 59220, Riyadh, 11525, Saudi Arabia.
• Eur Spine J. 2024 Sep 1; 33 (9): 340134083401-3408.

PurposeSurgical stabilization of the Atlas vertebrae is indicated for severe atlantoaxial instability (AAI) in patients with Down syndrome (DS). This study aims to evaluate the morphological characteristics of the Atlas lateral mass (ALM) in patients with DS with regard to safe instrumentation for surgical stabilization and to compare them with non-syndromic group.MethodsThis multicenter, retrospective, case-control study included age- and sex-matched patients with and without DS aged > 7 years with a cervical computed tomography (CT) scan. After three-dimensional CT reconstruction, nine parameters were evaluated for both groups. All included measurements were performed by a neuroradiologist who was blinded to clinical data.ResultsForty-three of 3,275 patients with DS were included in this study. Matching number of consecutive patients without DS were identified (mean age: 16 years). Patients with DS were significantly shorter than those without DS. Seven of nine parameters related to ALM were significantly lower in patients with DS than in those in the control group, including anterior wall height (AH), posterior wall height (PH), their ratio, and arch-ALM angle. On adjusting data for patient height, patients with DS had a smaller PH, lower PH/AH ratio, and steeper arch-ALM angle than the control group.ConclusionsPatients with DS had a smaller posterior ALM wall and a steeper arch-ALM angle than the control group without DS. This information is important for surgical planning of safe posterior ALM exposure and safe instrumentation for surgical stabilization in patients with DS.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

26 keywords...

hide…