title: An indirect reduction technique for ventral stabilization of atlantoaxial instability in miniature breed dogs.
abstract: OBJECTIVE
  To describe an indirect reduction method for ventral fixation of atlantoaxial instability.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Miniature dogs (n = 5) with atlanto-axial instability.
  
  
  METHODS
  For surgery, the anaesthetized dogs were positioned in dorsal recumbency. A standard ventral midline cranial cervical approach was used. The median part of the cervical (C) vertebral bodies of C1, C2 and C3 were exposed. After excision of the atlantoaxial joint capsule, a fenestration was performed at the C2-C3 intervertebral disc with a narrow slot in the ventral cranial endplate of C3. A midline incision of the atlanto-occipital membrane at the intercondyloid incisure was made to provide access to the spinal canal. Longitudinal distraction and realignment of C1-C2 were obtained by placing the tips of a Gelpi retractor in the two openings created. Overdistraction allowed removal of articular cartilage between C1-C2. Closing of the C1-C2 articular gap was finally achieved by applying lateral distraction with a second Gelpi retractor placed between the paired longus colli muscles. Fixation could then be performed without further stabilization.
  
  
  RESULTS
  No intraoperative complications were observed. Recovery was uneventful.
  
  
  CONCLUSIONS
  The described technique offered good surgical visibility and permitted safe reduction of atlantoaxial subluxation.
  
  
  CONCLUSIONS
  By reducing manipulation and instrumentation necessary for reduction of atlantoaxial instability, the described technique may be advantageous in toy-breed dogs.
authors.affiliation: Small Animal Clinic, Neurosurgery, Vetsuisse Faculty of Berne, Länggassstrasse 128, Berne, Switzerland. franck.forterre@vetsuisse.unibe.ch
authors.forename: F
authors.initials: F
authors.lastname: Forterre
authors.forename: N
authors.initials: N
authors.lastname: Vizcaino Revés
authors.forename: C
authors.initials: C
authors.lastname: Stahl
authors.forename: K
authors.initials: K
authors.lastname: Gendron
authors.forename: D
authors.initials: D
authors.lastname: Spreng
mesh_terms: D000818:Animals; D001268:Atlanto-Axial Joint / Q000473:pathology*; D049628:Body Size; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005260:Female; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods / Q000662:veterinary*; D012189:Retrospective Studies