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Caudal cervical spondylomyelopathy (CCSM)

Also: Wobbler

In caudal cervical spondylomyelopathy, neurological symptoms are caused by compression of the cervical spinal cord. This disease most commonly affects large dog breeds, especially the Great Dane and the Dobermann Pinscher. The etiology of CCSM is multifactorial and includes: vertebral instability, stenosis and/or malformation, intervertebral disc herniation and degenerative changes in the vertebral facet joints and ligaments. One or a combination of these abnormalities lead to progressive stenosis and compression of the cervical spinal cord. This compression may be dynamic, meaning the degree of compression varies with the position of the neck. Symptoms can occur in very young animals, but may also develop in later life. Typical CCSM signs are wide based pelvic limb ataxia and pseudohypermetria of the thoracic limbs, or unilateral thoracic limb lameness due to nerve root compression (root signature). The treatment options are conservative or surgical. Prognosis is always guarded and recidive of symptoms is common.

From AVOM viewpoint there is a vertebral misalignment in CCSM with ventral and minor cranial displacement along the antero-posterior axis. Correction of this misalignment with orthomanipulation relieves the spinal cord compression and symptoms.