George McAdoo is an active 6-year-old, 3-lb Yorkshire Terrier. George was hindered with weakness in his hind legs when he met Dr. Ryan Gallagher, a veterinary neurosurgeon with the Spine Center at VOSM (Veterinary Orthopedic Sports Medicine Group).
The Spine Center in Annapolis Junction, MD is a one-of-a-kind center specializing in advanced and innovative treatment for patients with back pain and injuries, including spinal diseases and disorders of the cervical, thoracic, and lumbar spine. Services include non-operative and operative treatments for spinal deformities, degenerative conditions, fractures, infections, tumors, and arthritis.
Dr. Gallagher, who heads up the Spine Center, completed his residency in neurology at North Carolina State University, one of the nation’s premier neurology training programs.
At their consultation appointment, George and his owners received a comprehensive review of George’s medical history, including the development and the progression of George’s symptoms.
“It is very important to understand the client’s hopes and expectations for the visit so that we make sure all possible concerns are addressed,” Dr. Gallagher said.
Once an initial review is completed of any new patient, a thorough examination is performed to identify
the presence, location, and severity of any neurological problems. Dr. Gallagher then takes all of this information and discusses the most likely conditions affecting the patient, and advises the most appropriate diagnostic or therapeutic options.
Based on the initial consultation, the physical examination, and x-rays, all four of George’s limbs were found to be abnormal, a condition consistent with a problem affecting the cervical spine. George’s ailment is called atlantoaxial luxation. It is a genetic birth defect that is a malformation of the spine. It causes the first two cervical vertebrae to be unstable. The instability can cause the vertebrae to bend abnormally, or luxate, which can cause significant spinal-cord compression, resulting in pain, weakness, and even breathing difficulties. Symptoms include neck pain, and varying degrees of incoordination and weakness or paralysis. In the case of breathing difficulties, the results could be fatal.
This birth defect most often afflicts small-breed dogs such as Yorkshire Terriers, Chihuahuas, Miniature or Toy Poodles, Pomeranians and Pekingese. Most cases of atlantoaxial luxation are discovered early in life because the condition exists at birth. George’s case is unusual because it wasn’t discovered until he was 6.
Dr. Gallagher presented two recommended courses of treatment for this defect. One is conservative management and the other is surgical stabilization. Conservative management is basically splinting of the neck. This involves an extended period of strict rest while wearing a neck brace and may also include medication. The neck brace and inactivity allow the ligaments around the vertebrae to strengthen and scar tissue to develop in order to stabilize the spine. It is most effective for young dogs with very recent symptoms that are mild in nature. While non-invasive, it poses its own set of risks in side effects and effectiveness. Surgical stabilization is the best chance for a cure. Depending on the nature of the defect, surgery can include inserting pins or plates and may require removing part of an abnormal vertebrae. It is a more permanent solution, but comes with the additional risks related to surgery. Besides the risk of respiratory failure during the procedure, the surgery is technically sensitive since it is working around the spinal cord.
VOSM recognizes the potential of many conditions to stabilize over time, and suitable diagnostic and non-operative measures are pursued as a first-line treatment, if appropriate. For severely painful conditions, cases of neurologic dysfunction, and when non-operative treatment has proven ineffective, surgery is pursued. The guiding philosophy of surgery at VOSM is to perform the smallest surgery in the most minimally invasive way possible that will reliably correct the disorder, with a minimum risk of medical complications or future problems.
After evaluating their options, weighing the risks, and considering the potential outcomes, George’s owners elected to proceed with surgery. Dr. Gallagher operated on George in September 2011. George pulled through the surgery very well and has made a complete recovery.
George is once again an active little Yorkie, but now he has a stable cervical spine. George’s story is one of the many success stories of The Spine Center resulting from Dr. Gallagher and VOSM’s mission of providing a standard of care that rivals what is available to humans and making. The Spine Center at VOSM one of the nation’s premier centers for spine and neurologic health.
Article by Susan Weaver is a freelance writer based in Elkridge, MD. Susan has written for accounting industry trade publications. She is the owner of Rosie, a cavapoo.