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- Author or Editor: Luc R. Borer x
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Abstract
Objective—To investigate a technique for repair of sacroiliac luxation with positional screw insertion from the ventral surface of the sacral wing via a ventral abdominal approach.
Sample Population—Hemipelvis specimens from cadavers of 5 small- to large-breed dogs and 9 European shorthair cats.
Procedures—An optimal entry point and a safe drill corridor for implant placement were determined (4 hemipelvis specimens). Anatomic landmarks were identified, and the surgical technique for a ventral abdominal approach was described. Single positional screw placement was performed across the sacroiliac joint in 23 hemipelvis specimens. Screws were aimed at 25°(n = 2), 35° (2), and 45° (19) angles to the vertical axis in a transverse plane (α angles) and at a 90° angle to the longitudinal axis in a dorsal plane (β angle). Implant placement was assessed by radiographic evaluation of the cadavers and of the hemipelvis specimens devoid of soft tissue.
Results—By use of α angles of 35° and 45°, 20 of 21 implants were placed adequately; screws crossed the sacroiliac joint and penetrated the wing of the ilium without damaging adjacent nerves. The measured median α angle was 38°, and the median β angle was 88°. One complication was recorded.
Conclusions and Clinical Relevance—Cortical positional screw placement from the ventral aspect of the sacral wing by use of a ventral abdominal approach could be an alternative to conventional techniques. This novel technique may be useful for repair of bilateral sacroiliac luxation, treatment of concomitant soft tissue injuries of the caudal portion of the abdominal cavity or abdominal wall, and repair of pelvic floor fractures in a single approach.
Abstract
Objective—To investigate sacroiliac luxation repair with positional screw insertion from the ventral surface of the sacral wing via a ventral abdominal approach in cats.
Animals—18 European shorthair cats.
Procedures—All cats underwent clinical examination including orthopedic and neurologic examination and assessment of lameness and pain before and immediately after surgery and 6 and 16 weeks after surgery. All sacroiliac luxations were stabilized with a single positional 2.4-mm cortical titanium self-tapping screw. The pelvic floor was also repaired in selected cats. Screw entry points and angles determined in a prior study of cadavers were used. Radiographs were taken before surgery and during follow-up evaluations to assess postoperative sacroiliac luxation reduction, implant placement, and repair stability.
Results—All implants were placed correctly. Iatrogenic sciatic nerve injuries occurred in 2 cats. Median time to ambulation was 1.5 days for cats with sacroiliac luxation as the sole injury. Radiographic outcome of sacroiliac luxation repair was excellent in 15 of 17 repairs, good in 1 of 17 repairs, and poor in 1 of 17 repairs. Clinical outcome was excellent in 11 of 15 cats and good in 4 of 15 cats.
Conclusions and Clinical Relevance—Insertion of a positional screw across the sacroiliac joint via a ventral abdominal approached can be an alternative to conventional techniques of sacroiliac luxation repair in cats. This novel technique allowed repair of bilateral sacroiliac luxation, repair of pelvic floor fractures, and treatment of soft tissue injuries of the abdominal cavity or abdominal organs with a single approach.
Abstract
Objective—To compare the analgesic and anti-inflammatory effect of single doses of carprofen, etodolac, meloxicam, and butorphanol in dogs with induced acute synovitis (acute pain model) via kinetic gait analysis and orthopedic evaluation and examine measurement of serum C-reactive protein (CRP) concentration as an indicator of treatment efficacy.
Animals—12 Beagles and 6 additional Beagles that were used only in serum CRP analyses.
Procedure—Acute synovitis was induced in right stifle joints of dogs via intra-articular injection of monosodium urate solution. Treatments included butorphanol (0.2 mg/kg, IV), carprofen (4 mg/kg, PO), etodolac (17 mg/kg, PO), or meloxicam (0.2 mg/kg, PO); control dogs received no treatment. The procedure was repeated (3-week intervals) until all dogs received all treatments including control treatment. Lameness was assessed on a biomechanical force platform and via orthopedic evaluations of the stifle joints; blood was collected to monitor serum CRP concentration.
Results—Compared with control dogs, treated dogs had significantly different vertical ground reaction forces and weight-bearing scores. Greatest improvement in lameness was observed in carprofen-treated dogs. Etodolac had the fastest onset of action. Compared with butorphanol treatment, only carprofen and etodolac were associated with significantly lower pain scores. An increase in serum CRP concentration was detected after intra-articular injection in all dogs; this change was similar among groups.
Conclusions and Clinical Relevance—Carprofen, etodolac, and meloxicam had greater efficacy than butorphanol in relief of acute pain. Carprofen was most effective overall. In this acute pain model, serum CRP analysis was not useful to assess drug efficacy. (Am J Vet Res 2003;64:1429–1437)
