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Vet Comp Orthop Traumatol 2018; 31(05): 344-355
DOI: 10.1055/s-0038-1661397
Original Research
Georg Thieme Verlag KG Stuttgart · New York

Computed Tomography and Biomechanical Comparison between Trans-Articular Screw Fixation and 2 Polymethylmethacrylate Cemented Constructs for Ventral Atlantoaxial Stabilization

Guillaume Leblond
1   Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
,
Noël M. M. Moens
1   Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
,
Luis Gaitero
1   Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
,
Alex zur Linden
1   Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
,
Fiona M. K. James
1   Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
,
Gabrielle Monteith
1   Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
,
Robert J. Runciman
2   School of Engineering, University of Guelph, Guelph, Ontario, Canada
› Author Affiliations Funding This work was supported by the Ontario Veterinary College Pet Trust Fund (grant number 050669, 2013). This study was ethically reviewed and approved by the University of Guelph Animal Care Committee (Animal utilization protocol no. 1899, approved on April 23, 2013). The data from this manuscript are extracted from a thesis submitted by G.L. to the University of Guelph's Department of Clinical Studies as partial fulfilment of the requirements for a Doctorate in Veterinary Science (DVSc). The results were partially presented orally at the annual American College of Veterinary Internal Medicine Forum (Indianapolis, Indiana, United States, June 2015).
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Publication History

02 October 2017

27 April 2018

Publication Date:
20 August 2018 (online)

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Abstract

Objectives Canine ventral atlantoaxial stabilization methods have been constantly evolving over the past few decades. Yet, proper experimental data comparing the feasibility and biomechanical properties of currently available surgical options are lacking. The aims of this study were (1) to describe and compare the safety profiles and biomechanical properties of three ventral atlantoaxial stabilization methods; and (2) to test whether recently reported optimal implant definitions constitute reasonable guidelines.

Methods Three types of atlantoaxial stabilization including trans-articular screw fixation (TSF) and two cemented constructs (MI5 and MI6) were performed in 21 Beagle cadavers. Post-surgical computed tomography (CT) images of the constructs and biomechanical data were then generated and statistically analysed.

Results The CT data revealed that TSF achieved significantly better apposition than cemented constructs. Out of 91 screws positioned, 4.4% were graded as dangerous and 86.8% as optimal. Optimal positioning was most challenging to obtain for mono-cortical screws. Analysis of biomechanical data suggested that all three techniques could likely achieve similar rates of atlantoaxial fusion when submitted to physiological loads but also that cemented constructs were less prone to failure compared with TSF.

Clinical Significance This study provides evidence that all three techniques are technically feasible and biomechanically viable but also that the evaluated surgical guidelines could be improved.

Keywords

atlantoaxial instability - dogs - computed tomography - biomechanics - spine surgery

Author Contributions

Guillaume Leblond, Noël M. M. Moens, Alex zur Linden and Robert J. Runciman contributed to conception of study, study design, and acquisition of data and data analysis and interpretation. Luis Gaitero, Fiona M. K. James and Gabrielle Monteith contributed to conception of study, study design and data analysis and interpretation. All authors drafted, revised and approved the submitted manuscript.


Supplementary Material

 

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