Rex, a 7 year old Labrador presented for evaluation of hindlimb ataxia and stumbling on his forelimbs. The signs had progressively occurred over a six month duration. Clinical examination revealed mild neck pain and spinatus muscle atrophy with neurolocalisation C6-T2 spinal cord segments. MRI imaging diagnosed chronic disc protrusion of C5/6 with nerve root foraminal compression, and malformation of the C6 vertebral body. A diagnosis of cervical spondylomyelopathy (wobbler syndrome) with significant disc protrusion was made. An additional collapsed C6/7 disc space noted, but was not causing any major spinal cord compression or neurological signs.
A distraction-fusion (stabilisation) technique was advised to stabilise the C5/6 vertebral motion unit to stop further disc protrusion through stabilisation and to and reduce the level of compression through distraction. This was performed with a titanium vertebral spacer after removal of a large portion of the disc and further stabilised with 2 x 2.7mm SOP locking plates. Cancellous bone graft and synthetic demineralised bone matrix were used to pack around the ventral cervical spine to encourage osseous bridging. Recovery from surgery was uneventful.
This case highlights again the importance of neurolocalisation as early cases of wobbler syndrome may only have mild spinatus muscle atrophy due to subtle nerve root compression. Most wobblers are middle aged Dobermans and other large breed dogs (Labrador, ACD, Retrievers). They are usually non-painful. Early diagnosis and surgical intervention can restore these dogs to close to normal long -term. Steroids have been suggested but do not work for anything but the short-term. Prognosis with distraction fusion is encouraging and generally around 85% of dogs will return to close to normal long-term function.