Atlanto axial subluxation

Question 1

What type of disease is atlantoaxial subluxation?

Answer 1

Congenital or developmental disease

Question 2

Which breed of dogs does it affect?

Answer 2

Immature toy breeds

Question 3

What causes the instability?

Answer 3

in the congenital form, instability of the joint results from a loss of intervertebral ligamentous support, often with concurrent aplasia, dysplasia or degeneration of dens.

Question 4

What neurological deficits can we see in AA instability?

Answer 4

Varies
Gait abnormalities - ataxia, pareses or tetraplegia
Respiratory compromise and death is possible

Acute or chronic spinal cord compression can explain the difference in the neurological deficits

Question 5

How do we diagnose AA instability?

Answer 5

RTG
CT - better for surgical planning
MRI - better information about spinal cord compression

Question 6

What about non-surgical treatment?

Answer 6

If treated within 30 days of symptoms - better outcome
nonsurgical management with cervical splint was viable treatment modality for young dogs with a first episode of acute-onset clinical signs -regardless of severity

Question 7

What factors influence good surgical outcome?

Answer 7

• age of onset (<24months)
• duration of clinical abnormalities (<10 months)
• lower preoperative neurological grading
• surgeon experience