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The parents of a 10-year-old boy with Down syndrome are seeking sports clearance for participation in the high jump at the Special Olympics. He is asymptomatic, and the neurologic examination is normal. The hips and patellae are clinically stable. Radiographs of the cervical spine in flexion and extension show a maximum atlanto-dens interval (ADI) of 6 mm. Based on these findings, what recommendation should be made?
Clearance for all sports activities
Avoidance of contact sports, high jump, and diving
Application of a hard cervical collar during sports events
Application of a halo vest
Posterior atlantoaxial arthrodesis
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