Zygomatic arch-atlas wing stabilization in 5 dogs with atlanto-occipital dislocation

J Vet Med Sci. 2016 Jul 1;78(6):963-70. doi: 10.1292/jvms.15-0421. Epub 2016 Feb 28.

Abstract

The aim of this work was to present a novel minimally invasive surgical stabilization technique for canine atlanto-occipital dislocation and to report the associated magnetic resonance imaging (MRI) findings. All 5 dogs in this case series underwent 1.5 T MRI of the head and neck and 3 underwent both MRI and computed tomography (CT). Atlanto-occipital dislocations were diagnosed based on the increased joint space between the occipital condyles and the atlas on MRI. Surgery was performed immediately with a never previously described fixation technique based on an external ligature. The stabilization was performed via 4 holes drilled in the zygomatic processes and in the atlas wings on each side. A nylon monofilament of 1 mm diameter was inserted in the 4 holes, and an O-shaped ligature was carried out externally to the skin through the ipsilateral zygomatic arch. Ligatures were removed within 2 months. At the postsurgical follow-up examination, 14 days after surgery, all dogs were found to be ambulatory. Atlanto-occipital stability was assessed by clinical examination with an average of 24 months of follow-up. The positive outcomes in this case series suggest that atlanto-occipital dislocation may be surgically treated with this novel technique, irrespective of the severity of the clinical presentation and associated lesions observed on MRI.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Cervical Atlas / diagnostic imaging
  • Cervical Atlas / injuries*
  • Cervical Atlas / surgery
  • Dogs / injuries*
  • Dogs / surgery
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / surgery
  • Joint Dislocations / veterinary*
  • Magnetic Resonance Imaging / veterinary
  • Male
  • Minimally Invasive Surgical Procedures / methods
  • Minimally Invasive Surgical Procedures / veterinary
  • Occipital Bone / diagnostic imaging
  • Occipital Bone / injuries*
  • Occipital Bone / surgery
  • Tomography, X-Ray Computed / veterinary
  • Zygoma / diagnostic imaging
  • Zygoma / surgery*