Traumatic atlanto-occipital luxation in a dog: associated hypoglossal nerve deficits and use of 3-dimensional computed tomography

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Steffen F, Flueckiger M, Montavon PM.

Vet Surg 2003;32:411-415.

OBJECTIVE: To present a detailed description of a dog with atlanto-occipital (A-O) luxation, including results of the neurologic examination, diagnostic imaging, and treatment by closed reduction. STUDY DESIGN: Clinical case report. SAMPLE POPULATION: One adult intact male German shepherd dog. RESULTS: Neurologic signs included nonambulatory tetraparesis and neck pain. An apparent hypoglossal nerve deficit was consistent with a lesion at the peripheral part of the nerve in the region of the craniocervical junction. Radiographic examination revealed a left-sided luxation of the A-O joint, and fractures were excluded with the aid of computed tomography (CT). Closed reduction of the luxated articulation resulted in a stable A-O joint, and complete neurologic recovery occurred within 4 weeks. CONCLUSIONS: Hypoglossal nerve deficits may be associated with A-O luxation. CLINICAL RELEVANCE: Closed reduction of a unilateral, traumatic luxation of the A-O joint is a therapeutic option in dogs. CT imaging, especially 3-dimensional reconstruction, was considered helpful in excluding fractures as well as defining treatment options.