Repair of fractured dens of the axis in a foal.

This research article focuses on a clinical case where a three-week old foal suffering from four-day-long quadriplegia was successfully treated through surgery. The quadriplegia was caused by a displacement of the dens of the axis, a part of the spine, due to a fracture. The surgical intervention managed to reduce the displacement and completely immobilize it. By the two-month post-surgical period, the foal was able to move adequately, with minor gait abnormalities noted only three years after the procedure.

Underlying Cause of the Quadriplegia

• The research illustrates a case where a 3-week old foal had been suffering from quadriplegia, a condition causing paralysis of all four limbs, lasting for 4 days. This state of immobility was due to the displacement of the dens of the axis.
• The ‘dens of the axis’ refers to a crucial part of the spine, responsible for allowing the head to rotate. The ‘axis’ is the second cervical vertebrae located in the neck and ‘dens’ is a protrusion on this vertebrae.
• The displacement of the dens happened due to a fracture at the ‘growth plate’ of the dens, an area of developing tissue at the end of long bones where the bone growth occurs.

Surgical Procedure and Post-Surgery Progress

• The surgical procedure involved the reduction of the displaced dens, thus bringing it back to its original position. Post this, the dens was immobilized to prevent any further displacement.
• Two months after the surgery, significant improvements were noted in the foal’s mobility. It was able to get up, walk, and trot independently, highlighting a successful surgical intervention with no apparent neurological deficiencies.

Long-Term Effects

• Three years post-surgery, the foal was monitored and only a single defect was observed: a mild gait disturbance in the left hindlimb. This anomaly was visible only during faster movements such as a canter and a gallop, implying that surgical intervention could largely restore the foal’s basic locomotor abilities.
• The mild disturbance can be considered minor considering the severity of the initial condition. This suggests that the surgical procedure for dens fracture can be extremely beneficial in treating quadriplegia caused by a similar condition.