Three‐dimensional printed dorsal occipitocervical fixation in a dog with atlantoaxial instability and concurrent incomplete ossification of the atlas

A 5-year-old, male, neutered, Border Collie presented to a referral hospital with marked cervical hyperaesthesia, uncharacteristic aggression and progressive tetraparesis. The dog was diagnosed with chronic, dynamic atlantoaxial instability and incomplete ossification of the atlas using combined advanced cross-sectional imaging. Traditional surgical approaches rely on adequate bone stock from both the atlas and the axis to achieve robust fixation, which would have been challenging in this case. Descriptive surgical techniques are lacking for this presentation due to its rarity. The owner consented to a novel surgical technique that used a three-dimensional (3D) printed titanium alloy plate to achieve dorsal occipitocervical fixation. A single screw deviated from it's intended corridor in the calvarium by 2.43 mm. The dog demonstrated transient worsening of neurological deficits and regained full ambulation 4 weeks post operative. 3D printing is becoming a popular adjunct in evolving surgical techniques and can be considered in both traditional and rare presentations.