Josie’s family noticed that she was having trouble walking and keeping her balance. After and examination by Dr. Rivera at BVNS Leesburg, we suspected she had an abnormality in her neck, most likely upper neck region. We discussed performing radiographs as we were most suspicious of an AA instability.

As suspected, the first two bones and ligaments in Josie’s neck developed abnormally, allowing them to move more than usual. The ideal way to treat atlanto-axial instability (AAI) which is causing neurological problems would be with surgery. However, considering how young and small Josie is, we recommended waiting until she is at least 1 year old in order for her bones will become denser and she would have a more successful surgery.

Josie is not in apparent pain and is able to walk, albeit with a wobbly gait. For the time being, we have placed a beautiful neck brace on her and are treating her with medical management; the hope being that she will continue to do well and possibly improve while we wait for her to mature. We will continue to monitor Josie and we will see if in a year, she will need surgery.