ABSTRACT
O objetivo deste trabalho foi apresentar uma variação na técnica de acesso ventral à articulação atlantoaxial para tratamento da instabilidade atlantoaxial sem a secção do músculo esternotireóideo. Foram utilizados 15 cães, pesando entre oito e 12kg, sem raça definida, independente do sexo, distribuídos aleatoriamente em três grupos iguais de acordo com o período pós-operatório (PO) denominados de I (30 dias), II (60 dias) e III (90 dias) para avaliações clínicas diárias. A articulação atlantoaxial foi submetida à artrodese por meio do acesso ventral utilizando pinos de Steinmann associados à resina acrílica autopolimerizável. O acesso e a exposição da articulação atlantoaxial sem a secção do músculo esternotireóideo foram realizados sem complicações ou limitações adicionais. Nenhum cão desta pesquisa apresentou tosse, dispnéia, regurgitação, paralisia laríngea ou Síndrome de Horner. Pode-se concluir que a secção do músculo esternotireóideo é um procedimento desnecessário e que não interfere na exposição da articulação atlantoaxial e na realização da artrodese em cães por meio do acesso ventral.
The aim of this research was to present a variation of the ventral technique access to the atlantoaxial joint, for treatment of atlantoaxial instability with no section of sternothyreoid muscle. Fifteen dogs, with weight between 8 and 12kg, were randomly distributed in three groups denominated one (30 days), two (60 days) and three (90 days) for daily clinical evaluations. The atlantoaxial joint was submitted to the arthrodesis through the ventral access using pins of Steinmann associated to acrylic resin. The access and exhibition of the atlantoaxial joint with no section of the sternothyreoid muscle was obtained without complications or additional limitations. No dog of this research presented coughing, dyspnea, regurgitation, laryngeal paralysis or Horner's syndrome. It can be concluded that the section of sternothyreoid muscle is an unnecessary procedure and that there is is no interference in the exhibition of atlantoaxial joint and arthrodesis approach of dogs through ventral access.
ABSTRACT
Atlantoaxial facet joint osteoarthritis is rare, often undiagnosed because it may be misdiagnosed as occipital neuralgia, or degenerative cervical spondylosis. Unilateral occipitocervical pain aggravated by head rotation is a specific symptom. Conservative treatment is usually effective. But when the patient complains of intractable neck pain localized to occipitocervical junction and unresponsive to medical therapy, surgical treatment should be considered. Though a few reports of surgically treated atlantoaxial osteoarthritis has been published, surgical outcome is favorable. A case of a surgically treated atlantoaxial osteoarthritis is presented with a review of the literatures.
Subject(s)
Humans , Head , Neck Pain , Neuralgia , Osteoarthritis , Spondylosis , Zygapophyseal JointABSTRACT
With the aim of determining the outcome of surgery, a review of patients undergoing trauma-associated atrantoaxial arthrodesis. Between 1993 and 1997, 16 patients underwent 19 proceedures, with a follow-up period of between six and 29 months. The most common reasons for surgery were odontoid fracture(n=12), os odontoideum(n=1) procedure, and neurofibrimatosis type I(n=1). Ten posterior wiring, four Halifax clamp application, one anterior screw fixation of dens, two transarticular screw fixations, and one staged operation(anterior odontoiddectomy and posterior occipitocervical fusion) were performed. All patients has been surgically managed for about three months with a Halo-vest or rigid cervical neck collar, during which time three complications associated with operative procedures arose : Halifax clamp dislodgement, malunion and subluxation kyposis. In 15 of 16 patients, fusion was successful. In caes involving complicated atlantoaxial dislocation, the authors recommend postoperative Halo-vest immobilization for sucessful fusion after posterior C1-C2 wiring or Halifax clamping