Caudal cervical arthrodesis using a distractable fusion cage in a dog

Adrega C. da Silva; F. Bernard; J.-F. Bardet

doi:10.3415/VCOT-09-02-0025

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2010; 23(03): 209-213
DOI: 10.3415/VCOT-09-02-0025

Case Report

Schattauer GmbH

Caudal cervical arthrodesis using a distractable fusion cage in a dog

Authors

Adrega C. da Silva

¹Small Animal Referral Clinic, Neuilly-sur-Seine, France
F. Bernard

²University Veterinary Hospital, School of Agriculture, Food Science & Veterinary Medicine, University College Dublin, Dublin, Ireland
J.-F. Bardet

¹Small Animal Referral Clinic, Neuilly-sur-Seine, France

Abstract

PDF Download

Summary

This case report describes a cervical fusion cage, surgical technique and the long-term outcome of caudal cervical arthrodesis used to stabilise dynamic spinal cord compression at the sixth and seventh cervical intervertebral disc space (C6, C7) in a dog. A seven-year-old, 41 kg, entire male Dobermann Pinscher was admitted for progressive ataxia of two weeks duration. Neurological examination revealed ambulatory tetraparesis. Computed tomographic myelogram scans in neutral and traction positions of the neck were performed and were used to determine presence of a dynamic component. A C6-C7 surgical distraction and stabilisation using a distractable intervertebral fusion cage was performed. There was not any deterioration of neurological status was observed on postoperative neurological evaluation. Within eight weeks after surgery, gait and postural abilities had returned to normal. Computed tomography evaluation indicated a complete bridging callus within and outside the cage at 15 weeks after surgery. There were not any complications or recurrences of initial neurological deficits observed during the 40 month follow-up period. Based on the follow-up period data, a C6-C7 dynamic spinal cord compression with disc protrusion was successfully treated by a distractable cervical fusion cage.

Keywords

Wobbler syndrome - fusion cage - bone fusion - dog

PDF (172 kb)

References

References
1 McKee WM, Sharp NJH. Cervical spondylopathy. In: Slatter DH. editor Textbook of Small Animal Surgery, Vol 1 3^rd ed Philadelphia: W.B. Saunders Co.; 2003: 1180-1192.
2 Sharp NJH, Wheeler SJ. Cervical spondylomyelopathy. In: Sharp NJH, Wheeler SJ. editors Small animal spinal disorders: diagnosis and surgery. 2^nd ed Edinburgh: Mosby; 2005: 211-246.
3 Jeffery ND, McKee WM. Surgery for disc-assocated wobbler syndrome in the dog- an examination of the controversy. J Small Anim Pract 2001; 42: 574-581.
4 da Costa R, Parent JM, Holmberg DL. et al. Outcome of medical and surgical treatment in dogs with cervical spondylomyelopathy: 104 cases (1988–2004). J Am Vet Med Assoc 2008; 233: 1284-1290.
5 Van Limbeek J, Jacobs WC, Anderson PG. et al. A systematic literature review to identify the best method for a single level anterior cervical interbody fusion. Eur Spine J 2000; 9: 129-36.
6 Tancredi A, Agrillo A, Delfini R. et al. Use of carbon fiber cages for treatment of cervical myeloradiculopathies. Surg Neurol 2004; 61: 221-226.
7 Wilke HJ, Kettler A.Claes. Primary stabilizing effect of interbody fusion devices for the cervical spine: an in vitro comparison between three different cage types and bone cement. Eur Spine J 2000; 9: 410-416.
8 Krayenbühl N, Schneider C, Landolt H. et al. Use of an empty, plasmapore-covered titanium cage for interbody fusion after anterior cervical microdiscectomy. J Clinical Neuroscience 2008; 15: 11-17.
9 Togawa D, Bauer TW, Brantigan JW. et al. Bone graft incorporation in radiographically successful human inter-vertebral body fusion cages. Spine 2001; 26: 2744-2750.
10 Slivka MA, Spenciner DB, Seim HB. et al. High rate of fusion in sheep cervical spines following anterior interbody surgery with absorbable and nonabsorbable implant devices. Spine 2006; 31: 1-7.
11 Wilke HJ, Kettler A, Goetz C. et al. Subsidence resulting from simulated postoperative neck movements: An in vitro investigation with a new cervical fusion cage. Spine 2000; 25: 2762-2770.
12 Bayley JC, Yoo JU, Kruger DM. et al. The role of distraction in improving the space available for the cord in cervical spondylosis. Spine 1995; 20: 771-775.
13 Jarzem PF, Quance DR, Doyle DJ. et al. Spine cord tissue pressure during spinal cord distraction in dogs. Spine 1992; 17 (Suppl) S227-S234.
14 Naito M, Owen JH, Bridwell KH. et al. Effects of distraction on physiologic integrity of the spinal cord, spinal cord blood flow, and clinical status. Spine 1992; 17: 1154-1158.
15 Koehler CL, Stover SM, LeCouteur RA. et al. Effect of a ventral slot procedure and of smooth or positive-profile threaded pins with polymethylmethacrylate fixation on intervertebral biomechanics at treated and adjacent canine cervical vertebral motion units. Am J Vet Res 2005; 66: 678-687.
16 Corlazzoli D. Bicortical implant insertion in caudal cervical spondylomyelopathy: a computed tomography simulation in affected Doberman pinschers. Vet Surg 2008; 37: 178-185.
17 Adamo PF, Kobayashi H, Markel M. et al. In vitro bio-mechanical comparison of cervical disk arthroplasty, ventral slot procedure, and smooth pins with polymethylmethacrylate fixation at treated and adjacent canine cervical motion units. Vet Surg 2007; 36: 729-741.
18 Dukti SA, Robertson JT, Bertone AL. et al. Examination of an equine wobbler twelve years after surgical placement of a Bagby basket. Vet Comp Orthop Traumatol 2004; 17: 107-109.
19 Fransson BA, Zhu Q, Bagley RS. et al. Biomechanical evaluation of cervical intervertebral plug stabilization in an ovine model. Vet Surg 2007; 36: 449-457.
20 Manunta ML, Careddu GM, Masala G. et al. Lumbar interbody expanding cage. Vet Comp Orthop Traumatol 2008; 21: 382-384.
21 Shamir MH, Chai O, Loeb E. A method for intervertebral space distraction before stabilization combined with complete ventral slot for treatment of disc-associated wobbler syndrome in dogs. Vet Surg 2008; 37: 186-192.
22 McKee WM, Butterworth SJ, Scott HW. Management of cervical spondylopathy-associated intervertebral disk protusions using metal washers in 78 dogs. J Small Animal Pract 1999; 40: 465-472.
23 Wilson ER, Aron DN, Robert RE. Observation of a secondary compressive lesion after treatment of caudal cervical spondylomyelopathy in a dog. J Am Vet Med Assoc 1994; 205: 1297-1299.
24 Demircan MN, Kutlay AM, Colak A. et al. Multilevel cervical fusion without plates, screws or autogenous iliac crest bone graft. J Clin Neurosci 2007; 14: 723-8.