Subscribe to RSS
DOI: 10.1055/s-0042-1750058
Basilar Invagination in a Cat with Incomplete Ossification of the Atlas Treated by C1-C2 Arthrodesis
Funding None.Abstract
Basilar invagination is a poorly described condition in veterinary medicine where the tip of the odontoid process projects into a normal foramen magnum. This report describes the clinical, radiological, and surgical treatment of a basilar invagination associated with instability of the atlantoaxial joint due to an incomplete ossification of the atlas in a cat. At presentation, the clinical signs included obtundation and non-ambulatory tetraparesis with postural reaction deficits in hindlimbs and left forelimb. Radiographic examination revealed cranial displacement of the axis with the dens impinging the basioccipital bone, and computed tomography confirmed the impaction of the axis on the atlas due to an incomplete ossification of the left half of the neural arch with the intercentrum. Magnetic resonance imaging confirmed severe spinal cord compression and myelopathy at this level. The cat underwent surgery for atlantoaxial arthrodesis using a ventral approach to C1-C2. Recovery after surgery was uneventful. Follow-up a year after surgery finds the cat free of neurological signs. An incomplete ossification of the atlas can lead to atlantoaxial instability and basilar invagination in the cat. Diagnosis can be made based on its radiological characteristics, the cranial displacement of the odontoid process in contact with the basioccipital bone being its main feature. This case was successfully treated by atlantoaxial arthrodesis.
Keywords
cat - ossification defects - feline occipitoatlantoaxial malformations - atlantoaxial arthrodesisPublication History
Received: 05 July 2021
Accepted: 19 December 2021
Article published online:
12 July 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Bailey CS, Morgan JP. Congenital spinal malformations. Vet Clin North Am Small Anim Pract 1992; 22 (04) 985-1015
- 2 Jaggy A, Hutto VL, Roberts RE. et al. Occipitoatlantoaxial malformation with atlantoaxial subluxation in a cat. J Small Anim Pract 1991; 32: 366-372
- 3 Watson AG, Hall MA, de Lahunta A. Congenital occipitoatlantoaxial malformation in a cat. Compend Contin Educ Pract Vet 1985; 7: 245-253
- 4 Sabuncuoglu H, Ozdogan S, Karadag D, Kaynak ET. Congenital hypoplasia of the posterior arch of the atlas: case report and extensive review of the literature. Turk Neurosurg 2011; 21 (01) 97-103
- 5 Watson AG, de Lahunta A, Evans HE. Morphology and embryological interpretation of a congenital occipito-atlanto-axial malformation in a dog. Teratology 1988; 38 (05) 451-459
- 6 Elvira T, Mateo I. Inestabilidad atlantoaxial con agenesia parcial del atlas en un perro. Clin Vet peq Anim 2020; 40: 93-98
- 7 Warren-Smith CM, Kneissl S, Benigni L, Kenny PJ, Lamb CR. Incomplete ossification of the atlas in dogs with cervical signs. Vet Radiol Ultrasound 2009; 50 (06) 635-638
- 8 Watson AG, Evans HE, de Lahunta A. Ossification of the atlas-axis complex in the dog. Anat Histol Embryol 1986; 15 (02) 122-138
- 9 Smith JS, Shaffrey CI, Abel MF, Menezes AH. Basilar invagination. Neurosurgery 2010; 66 (3, Suppl): 39-47
- 10 Pinter NK, McVige J, Mechtler L. Basilar invagination, basilar impression, and Platybasia: clinical and imaging aspects. Curr Pain Headache Rep 2016; 20 (08) 49
- 11 Cummings KR, Vilaplana Grosso F, Moore GE, Rochat M, Thomovsky SA, Bentley RT. Radiographic indices for the diagnosis of atlantoaxial instability in toy breed dogs [corrected]. Vet Radiol Ultrasound 2018; 59 (06) 667-676
- 12 Slanina MC. Atlantoaxial instability. Vet Clin North Am Small Anim Pract 2016; 46 (02) 265-275
- 13 Leblond G, Gaitero L, Moens NMM. et al. Computed tomographic analysis of ventral atlantoaxial optimal safe implantation corridors in 27 dogs. Vet Comp Orthop Traumatol 2017; 30 (06) 413-423
- 14 Loughin CA, Marino DJ. Atlantooccipital overlap and other craniocervical junction abnormalities in dogs. Vet Clin North Am Small Anim Pract 2016; 46 (02) 243-251
- 15 Bali MS. Diagnosis and surgical management of a fractured atlas in a cat. J Feline Med Surg 2011; 13 (04) 280-282
- 16 Wessmann A, McLaughlin A, Hammond G. Traumatic spinal cord injury caused by suspected hyperflexion of the atlantoaxial joint in a 10-year-old cat. JFMS Open Rep 2015; 1 (01) 2055116915589839
- 17 Goel A, Jain S, Shah A. Radiological evaluation of 510 cases of basilar invagination with evidence of atlantoaxial instability (group A basilar invagination). World Neurosurg 2018; 110: 533-543
- 18 Goel A, Nadkarni T, Shah A, Sathe P, Patil M. Radiologic evaluation of basilar invagination without obvious atlantoaxial instability (Group B basilar invagination): analysis based on a study of 75 patients. World Neurosurg 2016; 95: 375-382
- 19 Thomson MJ, Read RA. Surgical stabilization of the atlantoaxial joint in a cat. Vet Comp Orthop Traumatol 1996; 9: 36-39
- 20 Rotter C, Rusbridge C, Fitzpatrick N. Occipitoatlantoaxial malformation in a dog treated with a custom-made implant. VCOT Open 2020; 03 (02) e170-e176