Spine
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Two cases of symptomatic atlanto-axial dislocation in association with Down's syndrome are reported. The first patient showed spinal cord compression and had an ossiculum terminale; the second showed neck pain and had anteriorly inclined facet joint of the axis. ⋯ Both patients were treated successfully by posterior fusion of C1 and C2 in the maximally obtained position of reduction. In cases of symptomatic atlanto-axial dislocation when the spinal cord is at risk, surgical stabilization is the treatment of choice.