17 week-old Yorkie
Gracie, a 17 week-old female Yorkshire Terrier presented to Southeast Veterinary Neurology for evaluation of neck pain and weakness in all four of her legs. Gracie suddenly became painful and ataxic four days prior to presentation.
Radiographs of her neck by her veterinarian showed a condition called atlantoaxial subluxation.
Below are radiographs of Gracie before and after her neck splint was placed. Note the large space between the first two bones in Gracie’s neck prior to reduction.
Atlantoaxial subluxation is a condition seen primarily in young, small breed dogs where there is instability between the first and second cervical vertebrae. These two vertebrae are normally held together by a strong joint supported by bone and ligaments. However, some dogs are born with a weak attachment at this joint, which can lead to instability and subluxation. Subluxation at this location can cause spinal cord compression and bruising resulting in clinical signs of neck pain, weakness and even paralysis. Surgical fusion of the joint is the treatment of choice for dogs with atlantoaxial subluxation.
Due to Gracie’s young age, surgery was postponed for several months. Young dogs have softer bones making risk of failure of surgical fusion higher. Therefore, many dogs have to grow up a little before they can have surgery. While Gracie was waiting for surgery, she was managed with a splint around her neck.
Gracie was evaluated weekly until she was about 6 months of age. She was then admitted for surgical fusion of her neck. Below is her MRI used for surgical planning and to evaluate for spinal cord damage.
Dr. Freeman fused Gracie’s joint by placing screws in the first and second vertebrae of her neck. These screws were then joined using bone cement. Additionally a bone graft was used to promote bony fusion. Below is a radiograph performed immediately after surgery showing alignment of her bones and proper placement of the implants.
After surgery, Gracie had a smooth recovery. She is doing great at home, is comfortable and walking normally. She is starting to enjoy being a puppy again.
Referring radiographs showing atlantoaxial subluxation. Note the increased space between C1 and C2.
Gracie after placing a splint. Note that the subluxation is reduced.
Gracie’s pre-operative MRI. Note that there is still subluxation at C1-C2 (arrows).
Gracie after surgery. Notice the four small screws in C1 and C2. The bones are fused with a bone graft, screws and bone cement.