Salvage Stabilization via Transthoracic Approach for Congenital Vertebral Malformations in a Toy Breed Dog: A Case Report

This case report describes the successful management of a 7-month-old Pomeranian with congenital vertebral malformation (CVM) causing kyphosis and progressive myelopathy, characterized by non-ambulatory paraparesis, decreased postural reactions, and increased spinal reflexes in the hind limbs. Initial management involved a dorsal approach for decompression and stabilization; however, the patient failed to regain hindlimb function. Following two failed surgical attempts due to implant failure and progressive instability, a salvage stabilization was performed using a transthoracic approach. Stabilization was achieved using titanium screws and polymethyl methacrylate (PMMA) applied to the vertebral bodies. The patient exhibited marked postoperative improvement, regaining weight-bearing ability within one week and achieving a normal gait by four weeks. At the 19-month follow-up, the dog maintained normal ambulatory function with no recurrence of neurological deficits. While the transthoracic approach is well-documented in brachycephalic breeds, this is the first report describing its successful application in a toy breed. This case highlights the transthoracic approach as a highly effective salvage technique, offering a novel solution when conventional dorsal elements are irreversibly compromised due to the extremely diminutive and fragile nature of toy breed vertebrae.