How do we treat atlantoaxial subluxation?
Treatment for atlantoaxial subluxation can be surgical or conservative, depending on the severity of the condition. Your specialist will be able to advise on the best course of action for your pet.
Conservative management: If your pet is only suffering from mild symptoms, or if your pet has other medical conditions that make them a poor candidate for surgery, conservative management is likely to be recommended. This involves strict cage rest, along with your pet wearing a neck brace for several weeks. Painkillers and steroids may also be recommended to manage your pet’s discomfort. Although complete recoveries have been reported through conservative management, it’s likely your dog will suffer from continued instability, with an ongoing risk of sudden paralysis and death.
Surgery: Because of the risk of deterioration and paralysis with conservative management, surgery is usually the preferred course of action for treatment. The aim of surgery is to relieve the pressure on the spinal cord by fusing the atlas and axis vertebrae together into a normal position, enabling the spinal cord to heal. The preferred approach involves placing surgical screws into the atlas and axis bones and connecting the screws with bone cement, aiming to stabilise the atlantoaxial joint. The surgery has a success rate of 90%, compared to a 50% success rate for conservative management.
During the recovery period, animals with neck braces are often re-evaluated weekly. Animals who’ve had surgery will need to be evaluated between four and eight weeks after the surgery, during which time you’ll need to monitor your pet for any new or recurring symptoms.
The prognosis for atlantoaxial subluxation depends on how it’s managed. Although conservative treatment can improve your pet’s condition, there is a high chance of pain and spinal cord injury recurring, especially once the neck brace is removed.
The good news is that surgical treatment for atlantoaxial subluxation has a high success rate, especially for young dogs with mild symptoms. Surgery has a lower chance of success for older dogs or those suffering from more acute symptoms, such as paralysis, but significant recovery is still possible.
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