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Novel dorsal occipito-cervical fixation using a patient-specific implant and drill guide for a complex craniocervical
Tae-Wan Kwon1, Kyu-Won Kang1, Ji-Hey Lim2
1Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea.
Objective:
To describe a novel dorsal occipito-cervical fixation technique utilizing a patient-specific implant to stabilize complex craniocervical junction anomalies (CCJAs) in a small-breed dog.
Study Design:
Case report.
Animal:
A 7-month-old male Pomeranian dog.
Methods:
The dog presented with ambulatory tetraparesis and cervical pain. Advanced imaging revealed fusion of the C2-C4 vertebrae, occipital condyle hypoplasia, and atlas ventral arch hypoplasia, resulting in atlanto-occipital dislocation and atlantoaxial instability. A patient-specific dorsal occipito-cervical implant and implant-specific drill guide were designed from computed tomography (CT)-based three-dimensional models to incorporate predefined geometric constraints and planned screw trajectories, enabling controlled intraoperative realignment and dorsal stabilization.
Results:
Postoperative CT confirmed satisfactory alignment with no evidence of implant migration. Neurologic function improved gradually, with ambulation achieved by two months, and stability was maintained through 33 months of follow-up.
Conclusion:
This case demonstrated the feasibility of patient-specific dorsal occipito-cervical fixation in a small-breed dog with complex CCJAs.
