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Evaluation of nonsurgical treatment of atlantoaxial subluxation in dogs: 19 cases (1992–2001)

Marc E. Havig DVM1, Karen K. Cornell DVM, PhD, DACVS2, Julia C. Hawthorne DVM, DACVS3,4, John J. McDonnell DVM, DACVIM5,6, and Barbara A. Selcer DVM, DACVR7
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  • 1 Departments of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390.
  • | 2 Departments of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390.
  • | 3 Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907- 1243.
  • | 4 Present address is Veterinary Referral and Critical Care, 1596 Hockett Rd, Manakin Sabot, VA 23103.
  • | 5 Departments of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390.
  • | 6 Present address is Department of Clinical Sciences, Foster Hospital for Small Animals at Tufts University's Cummings School of Veterinary Medicine, North Grafton, MA 01536.
  • | 7 Departments of Anatomy and Radiology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390.

Abstract

Objective—To evaluate long-term neurologic outcome in dogs with atlantoaxial subluxation (AAS) that were treated nonsurgically with a cervical splint.

Design—Retrospective study.

Animals±19 dogs with AAS and managed with a cervical splint.

Procedure—Medical records from 2 university hospitals were reviewed. Information pertaining to trauma, duration of clinical signs prior to admission, medical treatments prior to admission, results of neurologic and physical examinations at the time of admission, results of laboratory testing, results of diagnostic imaging, neurologic status at the time of discharge, duration of time the cervical splint was used for treatment, and neurologic status at the time of splint removal and at a final reexamination was extracted from the medical records. Long-term outcome was defined as neurologic status greater than or equal to 1 year after splint removal. Factors associated with a good or poor long-term outcome were determined.

Results—A good final outcome was reported in 10 of 16 dogs. Median duration of clinical signs prior to referral was 30 days; dogs that were affected ≤ 30 days were significantly more likely to have a good long-term outcome, compared with dogs affected > 30 days. The neurologic grade at admission, radiographic appearance of the dens, age at onset of clinical signs, and history were not associated with outcome.

Conclusions and Clinical Relevance—Nonsurgical management of AAS by use of a cervical splint is a viable treatment modality for young dogs with a first episode of acute-onset clinical signs, regardless of the severity of neurologic deficits at admission. (J Am Vet Med Assoc 2005;227:257–262)

Abstract

Objective—To evaluate long-term neurologic outcome in dogs with atlantoaxial subluxation (AAS) that were treated nonsurgically with a cervical splint.

Design—Retrospective study.

Animals±19 dogs with AAS and managed with a cervical splint.

Procedure—Medical records from 2 university hospitals were reviewed. Information pertaining to trauma, duration of clinical signs prior to admission, medical treatments prior to admission, results of neurologic and physical examinations at the time of admission, results of laboratory testing, results of diagnostic imaging, neurologic status at the time of discharge, duration of time the cervical splint was used for treatment, and neurologic status at the time of splint removal and at a final reexamination was extracted from the medical records. Long-term outcome was defined as neurologic status greater than or equal to 1 year after splint removal. Factors associated with a good or poor long-term outcome were determined.

Results—A good final outcome was reported in 10 of 16 dogs. Median duration of clinical signs prior to referral was 30 days; dogs that were affected ≤ 30 days were significantly more likely to have a good long-term outcome, compared with dogs affected > 30 days. The neurologic grade at admission, radiographic appearance of the dens, age at onset of clinical signs, and history were not associated with outcome.

Conclusions and Clinical Relevance—Nonsurgical management of AAS by use of a cervical splint is a viable treatment modality for young dogs with a first episode of acute-onset clinical signs, regardless of the severity of neurologic deficits at admission. (J Am Vet Med Assoc 2005;227:257–262)