한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제25권2호
  • /
  • Pages.131-135
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  • 2008
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  • 1598-298X(pISSN)
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  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지

환축추 아탈구 견에서 투시기 유도를 통한 복측 나사 고정술

Ventral Fixation of Atlantoaxial Joint under Fluoroscopic Guidance Using Screws in a Chihuahua Dog

  • 이재훈 (건국대학교 수의과대학 수의외과학교실) ;
  • 양희택 (건국대학교 수의과대학 수의외과학교실) ;
  • 양우종 (건국대학교 수의과대학 수의외과학교실) ;
  • 정다정 (건국대학교 수의과대학 수의외과학교실) ;
  • 강은희 (건국대학교 수의과대학 수의외과학교실) ;
  • 엄기동 (건국대학교 수의과대학 수의방사선학교실) ;
  • 최치봉 (건국대학교 수의과대학 수의외과학교실) ;
  • 장화석 (건국대학교 수의과대학 수의외과학교실) ;
  • 김휘율 (건국대학교 수의과대학 수의외과학교실)
  • Lee, Jae-Hoon (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Yang, Hee-Taek (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Yang, Wo-Jong (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Chung, Dai-Jung (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Kang, Eun-Hee (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Eom, Ki-Dong (Department of Imaging and Diagnostic Radiology, College of Veterinary Medicine, Konkuk University) ;
  • Choi, Chi-Bong (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Chang, Hwa-Seok (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Kim, Hwi-Yool (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University)
  • 발행 : 2008.04.30
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초록

5연령의 치와와 견이 사지 부전마비를 평가하기 위해서 내원하였다. 내원 시에 보행이 불가능한 사지 부전마비와 목 부위 통증을 보였다. 방사선 상에서 환축추 아탈구와 C1 등쪽의 추궁과 C2의 가시돌기의 거리가 증가 된 소견을 보였다. 외과적 고정은 투시기 유도 하에서 복측 접근을 통하여 2개의 나사(screw)를 사용하여 실시하였으며, 외부 고정(neck brace)을 3주 동안 실시하였다. 수술 후 4주 후 임상증상이 개선되어 보행이 가능 하였으며, 방사선 상에서 고정을 유지하고 있었으며, 나사의 이주 소견은 없었다. 4개월 후에 임상증상이 완전히 회복되었다. 본 증례에서는 복측 나사 고정을 투시기 유도하에서 실시함으로, 나사의 적합한 각도로 위치 시킬 수 있었다.

A 5-year-old Chihuahua dog was evaluated for a tetraparesis. The dog was presented with a non-ambulatory tetraparesis and neck pain. Radiography demonstrated an atlantoaxial (AA) subluxation and increased distance between the dorsal arch of the C1 and the dorsal spinous process of the C2. The AA joint was fixed with ventral transarticular fixation using two screws under fluoroscopic guidance. Neck brace was applied during 3 weeks post-operation. After 4 weeks, the dog was fully ambulatory with improved neurological function. Postoperative radiographs confirmed reduction of the luxation and no migration of screws. The dog showed complete resolution of clinical signs without signs of recurrence till 4 months after operation. Proper angulations of screws provided under fluoroscopic guidance, enabled adequate stabilization of the AA joints using ventral transarticular screw fixation which improved neurologic outcome of the patient.

키워드

참고문헌

  1. Beaver DP, Ellison GW, Lewis DD, Goring RL, Kubilis PS, Barchard C. Risk factors affecting the outcome of surgery for atlantoaxial subluxation in dogs: 46 case (1978-1998). J Am Vet Med Assoc 2000; 216:1104-1109 https://doi.org/10.2460/javma.2000.216.1104
  2. Denny HR, Gibbs C, Waterman A. Atantoaxial subluxation in the dog: A review of thirty cases and an evaluation of treatment by lag screw fixation. J Small Anim Pract 1988; 29:37-47 https://doi.org/10.1111/j.1748-5827.1988.tb02262.x
  3. Havig ME, Cornell KK, Hawthorne JC, McDonnell JJ, Selcer BA. Evaluation of nonsurgical treatment of atlantoaxial subluxation in dogs: 19 cases (1992-2001). J Am Vet Med. Assoc. 2005; 227:257-262 https://doi.org/10.2460/javma.2005.227.257
  4. Jeffery ND. Dorsal cross pinning of the atlantoaxial joint: new surgical technique for atlantoaxial subluxation. J Small Ani Prac 1996; 37:26-29 https://doi.org/10.1111/j.1748-5827.1996.tb01930.x
  5. LeCouteur RA, McKeown D, Johnson J, Eger CE. Stabilization of atlantoaxial subluxation in the dog, using the nuchal ligament. J Am Vet Med Assoc 1980; 177:1011-1017
  6. Nicholas JS, Simon JW. Atlantoaxial subluxation. In: Small animal spinal disorders: diagnosis and surgery, 2nd ed. Mosby. 2005: 161-170
  7. McCarthy RJ, Lewis DD, Hosgood G. Atlantoaxial subluxation in dogs. Compend Contin Educ Pract Vet 1995; 17:215-227
  8. Platt SR, Chambers JN, Cross A. A modified ventral fixation for surgical management of atlantoaxial subluxation in 19 dogs. Vet Surg 2004; 33:349-354 https://doi.org/10.1111/j.1532-950X.2004.04050.x
  9. Sanders SG, Bagley RS, Silver GM, Moore M, Tucker RI. Outcomes and complications associated with ventral screws, pins, and polymethyl methacrylate for atlantoaxial instability in 12 dogs. J Am Anim Hosp Assoc 2004; 40:204-210 https://doi.org/10.5326/0400204
  10. Schulz K, Shires PK. Atlantoaxial instability. In: Bojrab MJ:Current techniques in small animal surgery, 4th ed. Philiadelphia, LWW, 1998: 817-822
  11. Schulz KS, Waldron DR, Fahie M. Application of ventral pins and polymethylmethacrylate for the management of atlantoaxial instability: Results in nine dogs. Vet Surg 1997; 26:317-325 https://doi.org/10.1111/j.1532-950X.1997.tb01504.x
  12. Shires PK. Atlantoaxial instability. In: Slatter D(ed): Textbook of small animal surgery, 3nd ed. Philiadelphia, Saunders, 1993: 1173-1180
  13. Shores A, Tepper LC. A modified ventral approach to the atlantoaxial junction in the dog. Vet Surg 2007; 36:765-770 https://doi.org/10.1111/j.1532-950X.2007.00334.x
  14. Sorjonen DC, Shires PK. Altantoaxial instability: A ventral surgical technique for decompression, fixation, and fusion. Vet Surg 1981; 1:22-29
  15. Thomas WB, Sorjonen DC, Simpson ST. Surgical management of atlantoaxial subluxation in 23 dogs. Vet Surg 1991; 20:409-412 https://doi.org/10.1111/j.1532-950X.1991.tb00348.x