Atlantoaxial Instability

Associations

  • Morquios
  • Spondyloepiphyseal dysplasia
  • Achondroplasia
  • Downs- 25% have instability
  • Pharyngeal infection in the normal child ( = Grisels syndrome)- due to hyperaemia causing demineralisation of the attachment of the transverse ligament to its attachment to the anterior arch of the atlas
  • rotatory subluxation or anterior subluxation

Atlanto dens interval

  • more than 5mm = instability
  • more than10mm = indication for surgery