Evaluation of a Novel Dorsal-Cemented Technique for Atlantoaxial Stabilisation in 12 Dogs.

Joana Tabanez,Veronica Gonzalo Nadal,Carina Rotter,Adriana Kaczmarska,Guillaume Leblond,Roberto José-López,Rodrigo Gutierrez-Quintana

doi:10.3390/life11101039

Joana Tabanez, Veronica Gonzalo Nadal + Show 5 more

Open Access

https://doi.org/10.3390/life11101039

Copy DOI

Abstract

Dorsal atlantoaxial stabilisation (DAAS) has mostly been described to treat atlantoaxial instability using low stiffness constructs in dogs. The aim of this study was to assess the feasibility and surgical outcome of a rigid cemented DAAS technique using bone corridors that have not previously been reported. The medical records of 12 consecutive dogs treated with DAAS were retrospectively reviewed. The method involved bi-cortical screws placed in at least four of eight available bone corridors, embedded in polymethylmethacrylate. Screw placement was graded according to their position and the degree of the breach from the intended bone corridor. All DAAS procedures were completed successfully. A total of 72 atlantoaxial screws were placed: of those, 51 (70.8%) were optimal, 17 (23.6%) were suboptimal, and 4 (5.6%) were graded as hazardous (including 2 minor breaches of the vertebral canal). Surgical outcome was assessed via a review of client questionnaires, neurological examination, and postoperative CT images. The clinical outcome was considered good to excellent in all but one case that displayed episodic discomfort despite the appropriate atlantoaxial reduction. A single construct failure was identified despite a positive clinical outcome. This study suggests the proposed DAAS is a viable alternative to ventral techniques. Prospective studies are required to accurately compare the complication and success rate of both approaches.

Highlights

Atlantoaxial instability (AAI) was first reported in dogs more than 50 years ago [1,2].Geary et al (1967) reported AAI in ten dogs of toy or miniature breeds; four of these dogs were managed surgically with a dorsal stabilisation technique using a simple wire loop [2]
Various treatment options have been reported with ventral techniques becoming more popular over time, likely due to lower reported mortality rates [3,4]
The present case series suggests that Dorsal atlantoaxial stabilisation (DAAS) cemented constructs can be safely performed to treat a wide range of craniocervical junction anomalies and traumatic injuries

Summary

Introduction

Geary et al (1967) reported AAI in ten dogs of toy or miniature breeds; four of these dogs were managed surgically with a dorsal stabilisation technique using a simple wire loop [2]. Other associated atlantoaxial congenital anomalies include incomplete ossification of the atlas (C1), separation of the dens from the axis (C2), and insufficient ligamentous support [5,6,7,8]. These malformations are more commonly encountered in young toy breed dogs [4,5,6]. Regardless of the underlying aetiology, the dorsal displacement of C2 into the vertebral canal leads to neurological deficits and/or pain [5]

Objectives

Methods

Results

Discussion

Conclusion