A modified ventral fixation for surgical management of atlantoaxial subluxation in 19 dogs

OBJECTIVE: To describe a modified ventral stabilization technique for surgical management of atlantoaxial subluxation in dogs and to evaluate the outcome. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Nineteen client-owned dogs. METHODS: Medical records of 19 dogs with a radiographic diagnosis of atlantoaxial subluxation surgically managed by a modified ventral fixation technique (cortical screws, Kirschner wires, polymethylmethacrylate) were reviewed. Data on pre- and post-operative neurologic status, surgical technique, and complications were retrieved. Follow-up evaluation was performed at approximately 1 month. Telephone interview of the owner was used for long-term assessment (median follow-up for 17 surviving dogs was 10.5 months). RESULTS: Adequate reduction and stabilization was achieved in all dogs based on radiographic assessment immediately after surgery. Improved neurologic outcome occurred in 16 dogs at 1 month and in 15 dogs at follow-up; 2 dogs died of post-operative complications within 24 hours of surgery. One dog was euthanatized at the owners' request because of recurrent neck pain associated with implant failure after 1 month. Two dogs required surgery to remove broken and migrated implants, but further stabilization was not necessary. CONCLUSIONS: Adequate stabilization and improved neurologic outcome was achieved in most dogs. However, on account of the small size of the study and the variable neurologic signs of the dogs on admission, the surgical technique described could not be compared to those previously reported. CLINICAL RELEVANCE: The surgical technique described is an effective means of surgical treatment for atlantoaxial subluxation.