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- Author or Editor: Franck Forterre x
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Abstract
OBJECTIVE
To determine whether a customized unilateral intervertebral anchored fusion device combined with (vs without) an intervertebral spacer would increase the stability of the L1-L2 motion segment following complete intervertebral diskectomy in canine cadaveric specimens.
SAMPLE
Vertebral columns from T13 through L3 harvested from 16 skeletally mature Beagles without thoracolumbar disease.
PROCEDURES
Complete diskectomy of the L1-2 disk was performed in each specimen. Unilateral stabilization of the L1-L2 motion segment was performed with the first of 2 implants: a unilateral intervertebral anchored fusion device that consisted of a locking compression plate with or without an intervertebral spacer. The resulting construct was biomechanically tested; then, the first implant was removed, and the second implant was applied to the contralateral side and tested. Range of motion in flexion and extension, lateral bending, and torsion was compared among intact specimens (prior to diskectomy) and constructs.
RESULTS
Compared with intact specimens, constructs stabilized with either implant were as stable in flexion and extension, significantly more stable in lateral bending, and significantly less stable in axial rotation. Constructs stabilized with the fusion device plus intervertebral spacer were significantly stiffer in lateral bending than those stabilized with the fusion device alone. No significant differences in flexion and extension and rotation were noted between implants.
CONCLUSIONS AND CLINICAL RELEVANCE
Findings did not support the use of this customized unilateral intervertebral anchored fusion device with an intervertebral spacer to improve unilateral stabilization of the L1-L2 motion segment after complete L1-2 diskectomy in dogs.
Abstract
OBJECTIVE
To compare the biomechanical properties of atlantoaxial joints (AAJs) in canine vertebral column specimens stabilized with 4 techniques (dorsal wire, modified dorsal clamp, ventral transarticular pin, and augmented ventral transarticular pin fixation) after transection of the AAJ ligaments.
Sample
13 skull and cranial vertebral column segments from 13 cadaveric toy-breed dogs.
PROCEDURES
Vertebral column segments from the middle aspect of the skull to C5 were harvested and prepared; AAJ ligament and joint capsule integrity was preserved. The atlantooccipital joint and C2 to C5 vertebral column segments were fixed with 2 transarticular Kirschner wires each. The occipital bone and caudalmost aspect of each specimen were embedded in polymethylmethacrylate. Range of motion of the AAJ under shear loading conditions up to 15 N was determined for each specimen during the third of 3 loading cycles with intact ligaments, after ligament transection, and after stabilization with each technique in random order. For each specimen, a load-to-failure test was performed with the fixation type tested last.
RESULTS
All stabilization techniques except for dorsal clamp fixation were associated with significantly decreased AAJ range of motion, compared with results when ligaments were intact or transected. The AAJs with dorsal wire, ventral transarticular pin, and augmented ventral transarticular pin fixations had similar biomechanical properties.
CONCLUSIONS AND CLINICAL RELEVANCE
Dorsal wire, ventral transarticular pin, and augmented ventral transarticular pin fixation increased rigidity, compared with results for AAJs with intact ligaments and for AAJs with experimentally created instability. Additional studies are needed to assess long-term stability of AAJs stabilized with these techniques.
Abstract
Objective—To describe the presence and amount of apoptotic ligamentous cells in different areas of partially ruptured canine cranial cruciate ligaments (prCCLs) and to compare these findings with apoptosis of ligamentous cells in totally ruptured cranial cruciate ligaments (trCCLs).
Animals—20 dogs with prCCLs and 14 dogs with trCCLs.
Procedures—Dogs with prCCLs or trCCLs were admitted to the veterinary hospital for stifle joint treatment. Biopsy specimens of the intact area of prCCLs (group A) and the ruptured area of prCCLs (group B) as well as specimens from trCCLs (group C) were harvested during arthroscopy. Caspase-3 and poly (ADP-ribose) polymerase (PARP) detection were used to detect apoptotic ligamentous cells by immunohistochemistry.
Results—No difference was found in the degree of synovitis or osteophytosis between prCCLs and trCCLs. No difference was found in degenerative changes in ligaments between groups A and B. A substantial amount of apoptotic cells could be found in > 90% of all stained slides. A correlation (rs = 0.71) was found between the number of caspase-3-and PARP-positive cells. No significant difference was found in the amount of apoptotic cells among the 3 groups. No significant correlation could be detected between the degree of synovitis and apoptotic cells or osteophyte production and apoptotic cells.
Conclusions and Clinical Relevance—The lack of difference between the 3 groups indicates that apoptosis could be a factor in the internal disease process leading to CCL rupture and is not primarily a consequence of the acute rupture of the ligament.
Abstract
OBJECTIVES
To describe a novel transforaminal approach for surgical excision of the atlantoaxial (AA) band and examine its feasibility, safety, and mechanical advantages in an ex vivo study and clinical cases.
SAMPLES
26 canine cadavers and 2 canine patients with AA bands.
PROCEDURES
The transforaminal approach via the first intervertebral foramen was designed to avoid damaging the dorsal AA ligament (DAAL) and dorsal laminas to maintain joint stability. The cadaveric study started on December 2020 and lasted 3 months. The ligamentum flavum (LF) was removed using a novel approach; then, gross examination was conducted to verify the potential damage to the spinal cord and associated structures and the adequacy of LF removal. Subsequently, the ex vivo tension test of the DAAL was conducted to establish whether the approach induced mechanical damage to the ligaments. Finally, 2 dogs diagnosed with an AA band were surgically treated with the transforaminal approach.
RESULTS
In the cadaveric study, postsurgical evaluation verified the subtotal removal of LF without damage to the dura mater. There were no significant differences in the mechanical properties of the DAAL, including the ultimate strength (P = .645) and displacement (P = .855), between the surgical and intact groups during the ex vivo tension test. In clinical cases, clinical signs and neurologic grades improved until the final follow-up.
CLINICAL RELEVANCE
The described surgical procedure using a transforaminal approach appears to sufficiently permit the removal of an AA band while reducing damage to the DAAL and spinal cord. Our study highlights the feasibility of the transforaminal approach.
Abstract
Objective—To compare severity of postoperative pain in dogs undergoing hemilaminectomy because of acute thoracolumbar intervertebral disk disease treated with a combination of conventional analgesics and electroacupuncture (EAP) or with conventional analgesics alone.
Design—Controlled clinical trial.
Animals—15 dogs undergoing surgery because of acute thoracolumbar disk disease.
Procedures—Dogs were alternately assigned to treatment (conventional analgesics and adjunct EAP) and control (conventional analgesics alone) groups. Analgesic treatment was adjusted as necessary by the attending clinician, who was not aware of group assignment. Pain scores were assigned 1, 3, and 12 hours after surgery and every 12 hours thereafter for 72 hours by the same individual who performed acupuncture treatments.
Results—Total dose of fentanyl administered during the first 12 hours after surgery was significantly lower in the treatment group than in the control group, but dosages of analgesics administered from 12 through 72 hours after surgery did not differ between groups. Pain score was significantly lower in the treatment group than in the control group 36 hours after surgery, but did not differ significantly between groups at any other time.
Conclusions and Clinical Relevance—Results provided equivocal evidence that adjunct EAP might provide some mild benefit in regard to severity of postoperative pain in dogs undergoing hemilaminectomy because of acute thoracolumbar intervertebral disk disease.
Abstract
Objective—To evaluate the accuracy of neurologic examination versus magnetic resonance imaging (MRI) in localization of cervical disk herniation and evaluate the usefulness of withdrawal reflex testing in dogs.
Design—Retrospective case series.
Animals—35 client-owned dogs with a single-level cervical disk herniation as determined via MRI.
Procedures—1 of 2 board-certified neurologists performed a complete neurologic examination in each dog. Clinical signs of a cervical lesion included evidence of neck pain and tetraparesis. The withdrawal reflex was used for neuroanatomic localization (C1-C5 or C6-T2). Agreement between results of neurologic and MRI examinations was determined.
Results—Agreement between neurologic and MRI diagnoses was 65.8%. In 11 dogs in which the lesion was clinically localized to the C6-T2 segment on the basis of a decreased withdrawal reflex in the forelimbs, MRI revealed an isolated C1-C5 disk lesion. In 1 dog, in which the lesion was suspected to be at the C1-C5 level, MRI revealed a C6-T2 lesion. Cranial cervical lesions were significantly associated with an incorrect neurologic diagnosis regarding site of the lesion.
Conclusions and Clinical Relevance—Results suggested that the withdrawal reflex in dogs with cervical disk herniation is not reliable for determining the affected site and that a decreased withdrawal reflex does not always indicate a lesion from C6 to T2.
Abstract
Objective—To determine the prevalence of spinal cord compression subsequent to traumatic intervertebral disk (IVD) extrusion in dogs, characterize factors associated with spinal cord compression in dogs with traumatic IVD extrusion, and evaluate the outcomes of dogs with traumatic IVD extrusion with or without spinal cord compression.
Design—Retrospective case series.
Animals—31 dogs with traumatic IVD extrusion.
Procedures—Medical records and MRI findings were reviewed for dogs with a history of trauma to the spinal region. Dogs were included in the study if a neurologic examination and MRI were performed and there was a description of clinical signs and MRI findings including identification of the spinal cord segment affected by IVD extrusion, presence or absence of spinal cord compression, treatment, and outcome available for review.
Results—31 of 50 (62%) dogs had traumatic IVD extrusions without any other detectable vertebral lesions; 9 (29%) and 22 (71%) of those 31 dogs did and did not have spinal cord compression, respectively. Dogs with spinal cord compression were significantly older and more likely to be chondrodystrophic and have evidence of generalized IVD degeneration, compared with dogs without spinal cord compression. The outcome for dogs with spinal cord compression was similar to that for dogs without spinal cord compression.
Conclusions and Clinical Relevance—Results indicated traumatic IVD extrusion was common and should be considered as a differential diagnosis for dogs with trauma to the spinal region, and spinal cord compression should be evaluated, especially in older or chondrodystrophic dogs.
Abstract
Objective—To examine outcome data for cats and dogs with congenital internal hydrocephalus following treatment via ventriculoperitoneal shunting to determine treatment-associated changes in neurologic signs, the nature and incidence of postoperative complications, and survival time.
Design—Retrospective multicenter case series.
Animals—30 dogs and 6 cats with congenital internal hydrocephalus (confirmed via CT or MRI).
Procedures—Medical records for dogs and cats with internal hydrocephalus that underwent unilateral ventriculoperitoneal shunt implantation from 2001 through 2009 were evaluated. Data collected included the nature and incidence of postoperative complications, change in clinical signs following surgery, and survival time. To compare pre- and postoperative signs, 2-way frequency tables were analyzed with a 1-sided exact McNemar test.
Results—8 of 36 (22%) animals developed postoperative complications, including shunt malfunction, shunt infection, and seizure events. Three dogs underwent shunt revision surgery. Thirteen (36%) animals died as a result of hydrocephalus-related complications or were euthanized. Following shunt implantation, clinical signs resolved in 7 dogs and 2 cats; overall, 26 (72%) animals had an improvement of clinical signs. After 18 months, 20 animals were alive, and the longest follow-up period was 9.5 years. Most deaths and complications occurred in the first 3 months after shunt placement.
Conclusions and Clinical Relevance—Results indicated that ventriculoperitoneal shunt implantation is a viable option for treatment of dogs or cats with congenital hydrocephalus. Because complications are most likely to develop in the first 3 months after surgery, repeated neurologic and imaging evaluations are warranted during this period.
