NECK FLEXION AND EXTENSION IN CHILDREN WITH DOWN-SYNDROME - A SOMATOSENSORY STUDY

The cervical spine in Down syndrome patients is often lax, at least at radiographic imaging, and the risk of spinal cord embarrassment is in creased. This study was performed to obtain information that would hel p identify patients at risk for this problem and reduce the risk of en dotracheal intubation and other surgical procedures in patients with D own syndrome. Somatosensory evoked potential studies were performed in 15 consecutive children who were undergoing elective otolaryngic surg ery. None had neurologic symptoms or the physical examination finding of cervical spinal cord embarrassment, and their cervical. spines were considered normal by plain radiographs obtained in the neutral, flexe d, and extended positions. No significant change in latency (P=.16) or amplitude (P=.19) was found when the anesthetized children had their necks placed in either full flexion or full extension. With more than 90% certainty, the authors believe that children with Down syndrome wh o have ''normal'' plain cervical spine radiographs are exposed to no e xtra risks from neck flexion or extension during surgery.