Novel dorsal occipito-cervical fixation using a patient-specific implant and drill guide for a complex craniocervical junction anomaly in a dog.

Patient-specific implants enable effective dorsal occipito-cervical fixation in complex craniocervical junction anomalies.

This case report describes a novel surgical approach for treating complex craniocervical junction anomalies (CCJAs) in a small-breed dog. A 7-month-old Pomeranian presented with ambulatory tetraparesis and cervical pain secondary to C2-C4 vertebral fusion, occipital condyle hypoplasia, atlas ventral arch hypoplasia, atlanto-occipital dislocation, and atlantoaxial instability. The surgical team designed a patient-specific dorsal occipito-cervical implant and matching drill guide using CT-based three-dimensional modeling, incorporating predefined geometric constraints and planned screw trajectories. This customized approach enabled precise intraoperative realignment and dorsal stabilization. Postoperative CT imaging confirmed satisfactory vertebral alignment without implant migration. The patient demonstrated gradual neurologic improvement, achieving ambulation within two months. Long-term follow-up at 33 months confirmed maintained stability and continued functional recovery. This case demonstrates the feasibility and potential benefits of patient-specific implant technology for managing complex CCJAs in small-breed dogs, offering an innovative solution for anatomically challenging spinal cases.

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