Fernandes Ricardo, Fitzpatrick Noel, Rusbridge Clare, Rose Jeremy, Driver Colin J
Fitzpatrick Referrals, Halfway Lane, Eashing, Godalming, GU7 2QQ UK.
School of Veterinary Medicine, Faculty of Health & Medical Sciences, Vet School Main Building (VSM), Daphne Jackson Road, Guildford, Surrey GU2 7AL UK.
Ir Vet J. 2019 Apr 23;72:2. doi: 10.1186/s13620-019-0141-9. eCollection 2019.
Disregarding atlantoaxial instability in toy breed dogs associated with dens malformation and cervical spondylomyelopathy; cervical vertebral malformations are rare and poorly characterised in veterinary medicine and consequently treatment strategies and clinical outcome are sparsely documented.
Electronic clinical records at our veterinary referral hospital between April 2009 and November 2018 were searched for patients presented with cervical myelopathy secondary to an underlying suspected vertebral malformation/instability. Nine dogs met the inclusion criteria. Two dogs were diagnosed with atlantoaxial pseudoarthrosis, two dogs with a syndrome similar to Klippel-Feil in humans, two dogs with congenital cervical fusion, two dogs with congenital C2-C3 canal stenosis and deficiencies of the dorsal arch of the atlas and laminae of the axis and one with axial rotatory displacement. Tetraparesis, proprioceptive deficits, cervical hyperesthesia and cervical scoliosis were the most common clinical signs. The axis was the most commonly affected vertebrae (8/9 patients). Patients diagnosed with Klippel-Feil-like Syndrome were the younger (average of 262.5 days) and patients diagnosed with fused vertebrae the oldest (average of 2896 days) in our studied population (average of 1580.8 days).
Cervical vertebral malformations are rare, or alternatively, being underdiagnosed in veterinary medicine. Patients diagnosed with Klippel-Feil-like Syndrome had a successful medium and long-term outcome with conservative management. Surgical treatment was often indicated for the other conditions presented in this study due to spinal instability and/or myelopathy. Stabilisations via ventral approaches were revealed to be safe. Multicentre and prospective studies are necessary in veterinary medicine to better characterise clinical outcomes in cervical vertebral malformations.
玩具犬种中与齿状突畸形和颈椎脊髓病相关的寰枢椎不稳常被忽视；颈椎畸形在兽医学中较为罕见且特征描述不足，因此治疗策略和临床结果的记录也很少。
检索了2009年4月至2018年11月期间我们兽医转诊医院的电子临床记录，以查找因潜在的疑似椎体畸形/不稳继发颈椎脊髓病的患者。9只犬符合纳入标准。2只犬被诊断为寰枢椎假关节，2只犬患有与人类Klippel-Feil综合征相似的综合征，2只犬患有先天性颈椎融合，2只犬患有先天性C2-C3椎管狭窄以及寰椎背弓和枢椎椎板缺损，1只犬患有轴向旋转移位。四肢轻瘫、本体感觉障碍、颈部感觉过敏和颈脊柱侧弯是最常见的临床症状。枢椎是最常受累的椎体（8/9例患者）。在我们的研究人群中（平均1580.8天），被诊断为Klippel-Feil样综合征的患者最年轻（平均262.5天），被诊断为椎体融合的患者最年长（平均2896天）。
颈椎畸形在兽医学中罕见，或者可能是诊断不足。诊断为Klippel-Feil样综合征的患者采用保守治疗取得了成功的中长期疗效。由于脊柱不稳和/或脊髓病，本研究中出现的其他情况通常需要手术治疗。经腹入路进行固定被证明是安全的。兽医学中需要多中心和前瞻性研究，以更好地描述颈椎畸形的临床结果。
