A Breakthrough in Canine Spine Surgery: New Technique Shows 93% Success Rate in Atlantoaxial Stabilization

Treatment of Canine Atlantoaxial Subluxation with a Modified Cervical Distraction–Stabilization Technique and Clinical Outcomes

Giuseppe Barillaro, Marco Tabbì, Simone Minniti, Nicola Maria Iannelli, Francesco Macrì, Claudia Interlandi

Background
Atlantoaxial subluxation (AAS) is a neurosurgical condition that results in cervical spine instability, particularly in toy-breed dogs. Traditional ventral fixation techniques have been associated with a high risk of implant failure. This study describes a modified cervical distraction–stabilization technique using screws and polymethylmethacrylate (PMMA) to treat AAS and evaluates its clinical outcomes in affected dogs.

Methods
Fourteen toy-breed dogs diagnosed with AAS underwent surgical stabilization using self-tapping cortical screws and PMMA. Preoperative MRI confirmed the diagnosis, while CT scans aided surgical planning. The technique involved a ventral approach with careful screw placement in C1 and C2, followed by PMMA application for stabilization. Neurological and radiographic follow-ups were conducted at 6 weeks (short-term) and 6 months (medium-term).

Results
Immediate postoperative neurological improvement was observed in all dogs, with a mean increase of two points on the neurological scale. At the 6-month follow-up, 93% (13/14) of the dogs showed normal neurological function with no pain, while one dog exhibited mild residual neck pain. No major complications, surgical revisions, or euthanasia cases were reported.

Limitations
The study included a small sample size, limiting its generalizability. Long-term follow-up data were not available, and radiographic confirmation of complete fusion was challenging due to PMMA use.

Conclusions
The modified cervical distraction–stabilization technique provided a safe and effective alternative for AAS treatment in toy-breed dogs, achieving excellent clinical outcomes with minimal complications. The approach offers improved stability while reducing the risk of implant-related failures compared to previous methods.

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