Gj. Halko et al., PATIENTS WITH TYPE-IV EHLERS-DANLOS SYNDROME MAY BE PREDISPOSED TO ATLANTOAXIAL SUBLUXATION, Journal of rheumatology, 22(11), 1995, pp. 2152-2155
Methods. Observational study of a selected cohort of patients with EDS
attending a national meeting, Twenty-six patients with EDS (19 with t
ype III; 3 with type IV; 1 each with types II and I; 2 with undefined
subtypes) were radiologically evaluated. Lateral flexion-extension vie
ws of the cervical spine in each patient were read in blinded fashion
by a radiologist and compared to unblinded interpretations made by a s
eparate radiologist. Measurement was taken from the most inferior aspe
ct of the anterior arch of C1 to the dens along a horizontal plane. Th
e remainder of the radiograph was examined for abnormalities. Results.
Two patients with EDS type IV had radiographic evidence of atlantoaxi
al subluxation (p = 0.013 Fisher's exact test), Evidence of horizontal
translation between vertebral bodies below C2 was noted in 3 patients
. Cervical arthrosis was present in 9. Conclusions. Atlantoaxial sublu
xation may be a more common finding in persons with type IV EDS than p
reviously thought, Examination of the cervical spine radiographically
should be considered before administering general anesthesia to these
patients.