ESTEBAN PUJOL, DVM 1,2 , BERNARD BOUVY, DVM, MS, Diplomate ACVS & ECVS 1,2 , MIGUEL OMAÑA, DVM 1,2 , MAR FORTUNY, DVM 1,2 , LUIS RIERA, DVM 1,2 , and PEDRO PUJOL, DVM 1,2 1 Department of Small Animal Surgery, Centre Hospitalier Vétérinaire Frégis, Arcueil, France ; and 2 Small Animal Clinic, "Canis," Palma de Mallorca, Balearic Islands, Spain Corresponding Author: Esteban Pujol, DVM, Department of Small Animal Surger Vet Surg January 2010 39 1 35-42 ABSTRACT Objective—To determine the applicability, complications, and long-term functional outcome of the Kishigami Atlantoaxial Tension Band (Kishigami AATB) for management of congenital and traumatic atlantoaxial (AA) instability in toy breed dogs. Study Design—Case series. Animals—Toy breed dogs (n=8) with congenital or traumatic AA instability. Methods—The AA joint of each dog was surgically stabilized through a dorsal approach using the original or a modified version of the Kishigami AATB. Pre- and postoperative neurologic status, radiographs, and complications were reviewed. Follow-up examination was performed at 1 and 12 months. Results—Functional improvement occurred in 5 dogs; 1 dog did not improve or worsen and 2 dogs were euthanatized at owner request. Adequate reduction and stabilization was achieved in 7 dogs based on immediate postoperative radiographs; failure of reduction was evident in 1 dog. No relevant complications occurred. Conclusions—Kishigami AATB may be acceptable as an alternative method for dorsal stabilization of AA subluxation in toy breed dogs in which use of ventral screws or pins is challenging. Experience with this technique in a larger population is necessary to compare our results to those reported by ventral approach. Clinical Relevance—The surgical technique described is effective, safe, and simple in the surgical treatment of AA subluxation in toy breed dogs.