References
Atlantoaxial subluxation: an overview and case report
Abstract
Atlantoaxial instability is a well-recognised cause of neck pain and spinal cord injury in dogs, particularly in small toy breeds such as Yorkshire terriers, Chihuahuas, and Toy Poodles. Clinical signs include spontaneous yelping, neck pain, low head carriage and tetraparesis. The cause of the instability is most often congenital, but it can occur following trauma. The condition can be managed medically using neck splints or neck bandages, analgesics, and rest. In some cases, this provides enough support for the ligaments to strengthen and support the joint, alleviating the spinal cord compression that causes the clinical signs. In some severe cases, surgery is required. This is an advanced and technical procedure that is best performed by experiences specialists, as it carries a high incidence of morbidity and mortality, especially in the first 48 hours post-surgery. However, surgery can lead to dramatic improvements and help the patient return to a normal quality of life.
The first two vertebrae in the neck, known as the atlas and axis, are unique. They are shaped differently from the rest of the cervical vertebrae and help with the pivot motion of the head. (Slanina, 2016). The atlas, the first vertebra, also known as C1, is located directly beneath the skull and articulates with the occipital bone and the axis. The axis, also known as C2, is situated just behind the atlas, and is the second vertebra in the neck. Unlike the other cervical vertebrae, the atlas does not have a dorsal spinous process but does have large transverse processes known as wings and a smaller vertebral body that forms a ventral arch (Slanina, 2016). The atlas and axis are connected by ligaments, with the axis featuring a rostral projection called the dens, which extends into the ventral arch of the atlas, where it is covered by a transverse ligament, aiding in stabilising the joint between the two vertebrae (Figures 1, 2).
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