PMID: 8597967Jan 1, 1995Paper

Preoperative evaluation of the cervical spine in children with trisomy-21: results of a questionnaire study

Paediatric Anaesthesia
R S LitmanF M Perkins

Abstract

Atlantoaxial subluxation (AAS) is a form of cervical spine instability predominantly found in persons with Trisomy-21. Several case reports describe the occurrence of acute AAS in the perioperative period. Some authors have recommended cervical spine radiographs prior to elective surgery in all children with Trisomy-21. The objective of this study was to determine practice patterns of North American members of the Society of Pediatric Anesthesia with regard to the perioperative evaluation and management of potential cervical spine instability in patients with Trisomy-21. Of 171 respondents, a minority of respondents (18%) obtain preoperative radiographs and/or subspecialty consultation (9%) in asymptomatic children with Trisomy-21. For symptomatic children the majority of respondents would obtain radiographs (64%) and/or preoperative consultation (74%). Approximately half of the respondents would attempt to maintain the head and neck in a neutral position for either asymptomatic (42%) or symptomatic (55%) patients. We conclude that the majority of respondents base their preoperative evaluation of the cervical spine on the signs and symptoms of the patient. This is supported by the literature reviewed, but is contrary to the rec...Continue Reading

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Citations

May 26, 1998·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·J C Bevan
Jan 11, 2016·Paediatric Anaesthesia·Amy Feldman LewandaMarshall Summar
Jun 19, 2003·Anesthesiology Clinics of North America·Semyon Fishkin, Ronald S Litman
Jul 14, 2006·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Sally R Shott
Jan 1, 1995·Paediatric Anaesthesia·V MitchellE Facer
Feb 26, 2005·Anesthesiology·Tara Hata, Michael M Todd
Dec 31, 2019·Paediatric Anaesthesia·Carlos Rogério Degrandi Oliveira

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