Laminectomy for relief of atlantoaxial subluxation in four horses

Malalignment of the atlas and axis was seen in 4 horses with an idiopathic form of atlantoaxial subluxation characterized by spinal cord compression on extension. The bone structure and density of the atlas and axis were radiographically normal in 3 of the 4 horses. Clinical signs appeared when the horses were 6 to 30 months old, and 3 of the 4 horses had a history of trauma. Although a congenital anomaly could not be ruled out, the cause was thought to be trauma. The horses were moderately to severely ataxic at the time of examination. Myelography revealed compression of the spinal cord at the atlantoaxial junction on extension. Flexion completely relieved the compression. In each horse, subtotal laminectomy of the caudal two thirds of the dorsal arch of the atlas was used to relieve the spinal cord compression. Two horses recovered fully, one had residual grade-1 neurologic deficits, and a fourth was euthanatized after it fractured a limb 6 weeks after surgery.