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Surgical management of atlantoaxial subluxation in 23 dogs.

Twenty-eight surgical procedures were performed in 23 dogs with atlantoaxial subluxation. Dorsal stabilization in seven dogs resulted in two recoveries and five failures of fixation. Ventral decompression and stabilization in 18 dogs resulted in eight recoveries and four failures of fixation. Six dogs died or were euthanatized within 7 days of ventral stabilization. Using either technique, four of seven nonambulatory dogs recovered.

Animals↗
PubMed1999

Human growth disorders: molecular genetics of the growth hormone-insulin-like growth factor I axis.

The critical role of the growth hormone-insulin-like growth factor I axis in controlling somatic growth in humans and other vertebrate species has been known for many years. Through molecular cloning and other related techniques many of the components of this axis have been characterized, with the most recent additions being key transcription factors required for pituitary development and for pituitary-specific gene expression. Several of these genes have been shown to be mutated in familial and sporadic human growth deficiency syndromes, thereby validating the central roles of the encoded proteins in the endocrine pathways regulating somatic growth. The purpose of this review is to highlight these recent advances from the perspective of the molecular genetics of human growth disorders.

Axis, Cervical Vertebra↗
PubMed2001

Atlantoaxial cartilaginous exostosis causing spinal cord compression in a mature Bernese mountain dog.

Cartilaginous exostosis developed in the atlantoaxial region of a three-and-a-half-year-old Bernese mountain dog. The dog exhibited ataxia in the hindlimbs and flailing movements in the forelimbs. On survey radiographs of the cervical spine there was a focal calcified mass between the dorsal arch of the atlas and the spinous process of the axis. Lumbar myelography revealed severe dorsal spinal cord compression. The mass was removed surgically and the dog made a complete recovery. Histopathology of the excised mass was consistent with a diagnosis of cartilaginous exostosis.

Animals↗
PubMed1982

Atlanto-axial malarticulation in Angora goats.

Two male Angora goats presented with ataxia and weakness of the hind limbs. Both tired easily when exercised and often stumbled and fell. In both cases, post-mortem examination revealed focal areas of gliosis and diffuse Wallerian degeneration in the spinal cord at the level of the atlanto-axial joint. There were also two areas of myelomalacia in one of the goats. In the other, the caudal articular surfaces of the atlas were unusually convex and the odontoid process of the axis was laterally compressed. It is suggested that these vertebral anomalies resulted in excessive mobility of the joint leading to the development of a compressive myelopathy.

Animals↗
PubMed1988

Atlantoaxial instability and abnormalities of the odontoid in Down's syndrome.

Radiography of the lateral neck was performed on all children with Down's syndrome aged 4-15 in the Southern Derbyshire health district (n = 67) and a random selection of adults (n = 94). Atlantoaxial instability, defined as a gap of over 4 mm, was present in seven (10%) children and two (2%) adults. Odontoid hypoplasia, defined as an odontoid peg two standard deviations below the mean in an age matched population, was present in 15 (22%) children and 14 (15%) adults, with accessory odontoid ossicles present in two (2%) and two (3%) respectively. No one was found to have symptoms or clinical signs of spinal cord compression. Atlantoaxial instability was therefore found to be commoner in children than adults. Different programmes of management are suggested, in terms of regular clinical examination for signs and symptoms and by radiographic screening. Particular care should be taken with those who have both atlantoaxial instability and odontoid hypoplasia or accessory ossicles as they are at particular risk of spinal cord damage.

Adolescent↗
PubMed2004

How to diagnose axial spondyloarthritis early.

BACKGROUND: Chronic low back pain (LBP), the leading symptom of ankylosing spondylitis (AS) and undifferentiated axial spondyloarthritis (SpA), precedes the development of radiographic sacroiliitis, sometimes by many years. OBJECTIVE: To assign disease probabilities and to develop an algorithm to help in the early diagnosis of axial SpA. METHODS: Axial SpA comprises AS and undifferentiated SpA with predominant axial involvement. Clinical features include inflammatory back pain (IBP), alternating buttock pain, enthesitis, arthritis, dactylitis, acute anterior uveitis, a positive family history, psoriasis, inflammatory bowel disease, and good response to NSAIDs. Associated laboratory findings include raised acute phase reactions, HLA-B27 association, and abnormalities on skeletal imaging. Sensitivities, specificities, and likelihood ratios (LRs) of these parameters were determined from published studies. A 5% prevalence of axial SpA among patients with chronic LBP was used. The probability of the presence of axial SpA, depending on the presence or absence of the above clinical features of SpA, was determined. A probability of > or = 90% was used to make a diagnosis of axial SpA. RESULTS: The presence of inflammatory back pain features increased the probability of axial SpA from the background 5% prevalence to 14%. The presence of 2-3 SpA features was necessary to increase the probability of axial SpA to 90%. The highest LRs were obtained for HLA-B27 and MRI. Diagnostic algorithms to be used in daily practice were suggested. CONCLUSIONS: This approach can help clinicians to diagnose with a high degree of confidence axial SpA at an early stage in patients with IBP who lack radiographic sacroiliitis.

Axis, Cervical Vertebra↗