Modified Stabilization Technique Following Resection of a Massive Cervical Infiltrative Lipoma with Spinal...

Infiltrative lipomas involving the upper cervical spine present a significant surgical challenge, as the extensive muscular resection required for tumor control often leads to severe structural instability. This report describes the surgical treatment of an infiltrative lipoma that extensively invaded the cervical area in a 9-year-old dog. Following wide surgical debulking, a dual-plane stabilization strategy was employed. Ventral stabilization was attempted using standard C1-C2 transarticular screw fixation, while a modified dorsal stabilization technique anchored the occipital protuberance to the C2 spinous process using an ultra-high molecular weight polyethylene (UHMWPE) suture construct, combined with nuchal ligament reconstruction. Follow-up at 78 days revealed failure of the ventral implants, characterized by immediate improper positioning of the right screw and subsequent migration of the left screw. Despite these complications and confirmed tumor recurrence, the patient maintained normal neurological function and clinical cervical stability. This clinical course was suggestive of fibrous or early osseous union at the atlantoaxial joint. These findings suggest that the modified dorsal stabilization technique provided critical biomechanical support, effectively compensating for the compromised ventral fixation, and may represent a potential surgical option for managing extensive occipito-cervical instability in dogs.