Atlanto-axial approach for cervical myelography in a thoroughbred horse with complete fusion of the atlanto-occipital bones

A 2-year-old Thoroughbred gelding with clinical signs localized to the first 6 spinal cord segments (Cl to C6) had complete fusion of the atlanto-occipital bones which precluded performing a routine myelogram. An ultrasound-assisted myelogram at the intervertebral space between the atlas and axis was successfully done and identified a marked extradural compressive myelopathy at the level of the atlas and axis, and axis and third cervical vertebrae.