# Modified Stabilization Technique Following Resection of a Massive Cervical Infiltrative Lipoma with Spinal Compression in a Dog

## TL;DR

A dog with a large cervical lipoma underwent surgery and dual-plane stabilization, showing that the dorsal technique can maintain stability even after ventral implant failure.

## Contribution

A modified dorsal stabilization technique is proposed as a viable option for managing severe cervical instability in dogs with infiltrative lipomas.

## Key findings

- The modified dorsal stabilization technique maintained cervical stability despite ventral implant failure and tumor recurrence.
- The dog retained normal neurological function following the surgical intervention.
- The dorsal stabilization may have provided biomechanical support through fibrous or early osseous union at the atlantoaxial joint.

## Abstract

This report describes a dog with a large infiltrative lipoma involving the upper cervical spine, requiring an extensive tumor resection that resulted in marked upper cervical instability. Dual-plane stabilization was performed using ventral transarticular screws and a braided ultra-high molecular weight polyethylene (UHMWPE) suture-based dorsal stabilization. Despite ventral implant failure and tumor recurrence, the dog maintained normal neurological function and cervical stability. These findings indicate that the dorsal technique may be a useful option for managing severe occipito-cervical instability in dogs.

Infiltrative lipomas involving the upper cervical spine present a significant surgical challenge, as the extensive muscular resection required for tumor control often leads to severe structural instability. This report describes the surgical treatment of an infiltrative lipoma that extensively invaded the cervical area in a 9-year-old dog. Following wide surgical debulking, a dual-plane stabilization strategy was employed. Ventral stabilization was attempted using standard C1–C2 transarticular screw fixation, while a modified dorsal stabilization technique anchored the occipital protuberance to the C2 spinous process using an ultra-high molecular weight polyethylene (UHMWPE) suture construct, combined with nuchal ligament reconstruction. Follow-up at 78 days revealed failure of the ventral implants, characterized by immediate improper positioning of the right screw and subsequent migration of the left screw. Despite these complications and confirmed tumor recurrence, the patient maintained normal neurological function and clinical cervical stability. This clinical course was suggestive of fibrous or early osseous union at the atlantoaxial joint. These findings suggest that the modified dorsal stabilization technique provided critical biomechanical support, effectively compensating for the compromised ventral fixation, and may represent a potential surgical option for managing extensive occipito-cervical instability in dogs.