Rev Esp Med Legal. 2018;44(2):73---82 www.elsevier.es/mlegal Spanish Journal of Legal Medicine Revista Española de Medicina Legal REVIEW Cervical synostosis associated with Down’s syndrome and Schneider syndrome. Clinical and medico-legal implications of an autopsy case  José Manuel Arredondo Diaz a , José Aso Escario b,c,* , Jesús Obon d , Cristina Sebastián Sebastián e , Alberto Aso Vizan f , José-Vicente Martínez Qui˜ nones b a Servicio de Clínica Forense, Instituto de Medicina Legal de Aragón, Zaragoza, Spain b Servicio de Neurocirugía, Hospital MAZ, Zaragoza, Spain c Facultad de Ciencias de la Salud, Universidad San Jorge, Zaragoza, Spain d Instituto de Medicina Legal de Aragón, Zaragoza, Spain e Servicio de Radiodiagnóstico, Hospital MAZ, Zaragoza, Spain f Servicio de Traumatología y Cirugía Ortopédica, Hospital General de la Defensa, Zaragoza, Spain Received 15 June 2017; accepted 4 September 2017 Available online 30 March 2018 KEYWORDS Vertebral synostosis; Klippel---Feil; Down’s syndrome; Spinal cord contusion; Schneider syndrome; Autopsy Abstract This paper reviews the association of clinical symptoms and their clinical and foren- sic implications in a patient with Down’s syndrome and congenital cervical synostosis who experienced a traumatic spinal cord injury. To date, no prevalent association between Down’s syndrome and cervical synostosis has been reported in the literature. Given that both entities are prone to cause degenerative or traumatic cervical myelopathy, the combination of both conditions must be seen as a risk factor for spontaneous, and particularly traumatic, spinal cord damage. In these cases, radiological examination must be exhaustive, including MRI, given the possibility of spinal cord injury even after minimal trauma. In the event of death, spinal cord autopsy is mandatory as it may reveal subclinical lesions, clarify the nature and extension of the spinal cord and skeletal injuries and help to establish an improved anatomo-clinical correlation. © 2017 Asociaci´ on Nacional de M´ edicos Forenses. Published by Elsevier Espa˜ na, S.L.U. All rights reserved. DOI of original article: http://dx.doi.org/10.1016/j.reml.2017.09.002  Please cite this article as: Arredondo Diaz JM, Aso Escario J, Obon J, Sebastián Sebastián C, Aso Vizan A, Martínez Qui˜ nones J-V. Sinostosis cervical asociada a síndromes de Down y de Schneider. Implicaciones clínicas y médico-legales a propósito de un caso autópsico. Rev Esp Med Legal. 2018;44:73---82. * Corresponding author. E-mail address: jaso@maz.es (J. Aso Escario). 2445-4249/© 2017 Asociaci´ on Nacional de M´ edicos Forenses. Published by Elsevier Espa˜ na, S.L.U. All rights reserved.