Atlanto-axial instability (AAI) is a condition that affects approximately 15% of people with Down Syndrome. In AAI, the ligaments (elastic bands of tissue that connect one bone to another) that support the first and second vertebrae in the neck are looser than normal As a result, a person with AAI is at risk for injury to the spinal cord, which passes through those two bones. Only 1 ? 2% of people with AAI have any symptoms. These include neck pain, numbness and tingling in the extremities, difficulty walking, limited neck mobility, head tilt and abnormal gait. Even without symptoms, people with AAI are still at risk for serious injury from any activity that puts strain on the neck.

AAI can be diagnosed with an x-ray and all children with Down syndrome should have this test between the ages of 2-1/2 and 3 years. If your child has AAI but has not developed symptoms, your doctor will probably recommend that your child refrain from certain activities such as contact sports, diving and gymnastics. If your child develops symptoms fusion surgery may be necessary.

It is possible for a person to develop AAI after early childhood, even if he or she was normal on pervious assessments. Some authorities recommend x-rays at 3, 13 and 18 years. Others believe they should be done more frequently. Your child should certainly be checked before any new sporting activity or before any surgical procedure that requires a general anesthetic. For more information, speak to your health care professional or contact the Center at 621-5858 or (in Ohio only) (800) 899-3039.

Reprinted with permission from: Center for Mental Retardation magazine..