ABSTRACT
Atlantoaxial dislocation is common in patients with Down syndrome, and an increased incidence was first noted by Tishler and Martel in 1965. Laxity of the transverse atlantal ligament is thought to be responsible for atlantoaxial dislocation, and surgical stabilization has been recommended for pateints who have instability, with or without myelopathy. Various surgical techniques and hardwares have been developed for occipitcervical fusion with varying degrees of results. The authors presents a case of Down syndrome with cervical myelopathy treated by occipitocervical fusion with an anatomically contoured threaded Steinmann-pin, which was secured to the occiput via small burr holes and to the vertebrae by sublaminar wiring, and supplemental autograft. This technique has the advantage over bone grafting, in that it affords rigid stabilization, allows early mobilization and may contribute to eventual bony fusion.