Kinematics of a Novel Canine Cervical Fusion System

Abstract

Objective The aim of this study was to determine the biomechanical behaviour of a novel distraction–fusion system, consisting of an intervertebral distraction screw, pedicle locking screws and connecting rods, in the canine caudal cervical spine.

Study Design Biomechanical study in cadaveric canine cervicothoracic (C3–T3) spines (n = 6). Cadaveric spines were harvested, stripped of musculature, mounted on a four-point bending jig, and tested using non-destructive four-point bending loads in extension (0–100 N), flexion (0–60 N) and lateral bending (0–40 N). Angular displacement was recorded from reflective optical trackers rigidly secured to C5, C6 and C7. Data for primary and coupled motions were collected from intact spines and following surgical stabilization (after ventral annulotomy and nucleotomy) with the new implant system.

Results As compared with the intact spine, instrumentation significantly reduced motion at the operated level (C5-C6) with a concomitant non-significant increase at the adjacent level (C6-C7).

Conclusion The combination of a locking pedicle screw-rod system and intervertebral spacer provides an alternative solution for surgical distraction–stabilization in the canine caudal cervical spine and supports the feasibility of using this new implant system in the management of disc-associated cervical spondylomyelopathy in dogs. The increase in motion at C6-C7 may suggest the potential for adjacent level effects and clinical trials should be designed to address this.

Keywords

canine - cervical - fusion - biomechanics

Note

Results of this study were presented at the 24th Annual Scientific Meeting of the European College of Veterinary Surgeons, Berlin, Germany, July 2-4, 2015.

Authors' Contributions

C.Z., N.F., A.S.L. and M.J.A. contributed to the conception of the study, study design and acquisition of data. C.Z., A.S.L. and M.J.A. analysed the data. C.Z., N.F. and M.J.A. drafted, revised and approved the submitted manuscript. All the authors have reviewed and approved the final version.

Publikationsverlauf

Eingereicht: 10. Oktober 2020

Angenommen: 19. Januar 2021

Artikel online veröffentlicht:
15. April 2021

• References

• 1 da Costa RC. Cervical spondylomyelopathy (wobbler syndrome) in dogs. Vet Clin North Am Small Anim Pract 2010; 40 (05) 881-913
• 2 Baskin JJ, Vishteh AG, Dickman CA. et al. Techniques of anterior cervical plating. Oper Tech Neurosurg 1998; 1: 90-102
• 3 Cherrone KL, Dewey CW, Coates JR, Bergman RL. A retrospective comparison of cervical intervertebral disk disease in nonchondrodystrophic large dogs versus small dogs. J Am Anim Hosp Assoc 2004; 40 (04) 316-320
• 4 Fauber AE, Wade JA, Lipka AE, McCabe GP, Aper RL. Effect of width of disk fenestration and a ventral slot on biomechanics of the canine C5-C6 vertebral motion unit. Am J Vet Res 2006; 67 (11) 1844-1848
• 5 Adamo PF, Kobayashi H, Markel M, Vanderby Jr R. In vitro biomechanical 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 (08) 729-741
• 6 Hakozaki T, Ichinohe T, Kanno N. et al. Biomechanical assessment of the effects of vertebral distraction-fusion techniques on the adjacent segment of canine cervical vertebrae. Am J Vet Res 2016; 77 (11) 1194-1199
• 7 Yang H, Lambrechts NE, Lehner M. et al. Effects of conventional and slanted ventral slot procedures on the biomechanical behavior of the C5-C6 vertebral motion unit in dogs. Am J Vet Res 2016; 77 (08) 846-853
• 8 Koehler CL, Stover SM, LeCouteur RA, Schulz KS, Hawkins DA. 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 (04) 678-687
• 9 Hicks DG, Pitts MJ, Bagley RS. et al. In vitro biomechanical evaluations of screw-bar-polymethylmethacrylate and pin-polymethylmethacrylate internal fixation implants used to stabilize the vertebral motion unit of the fourth and fifth cervical vertebrae in vertebral column specimens from dogs. Am J Vet Res 2009; 70 (06) 719-726
• 10 Hettlich BF, Allen MJ, Pascetta D, Fosgate GT, Litsky AS. Biomechanical comparison between bicortical pin and monocortical screw/polymethylmethacrylate constructs in the cadaveric canine cervical vertebral column. Vet Surg 2013; 42 (06) 693-700
• 11 Agnello KA, Kapatkin AS, Garcia TC, Hayashi K, Welihozkiy AT, Stover SM. Intervertebral biomechanics of locking compression plate monocortical fixation of the canine cervical spine. Vet Surg 2010; 39 (08) 991-1000
• 12 Schöllhorn B, Bürki A, Stahl C, Howard J, Forterre F. Comparison of the biomechanical properties of a ventral cervical intervertebral anchored fusion device with locking plate fixation applied to cadaveric canine cervical spines. Vet Surg 2013; 42 (07) 825-831
• 13 Voss K, Steffen F, Montavon PM. Use of the ComPact UniLock System for ventral stabilization procedures of the cervical spine: a retrospective study. Vet Comp Orthop Traumatol 2006; 19 (01) 21-28
• 14 Trotter EJ. Cervical spine locking plate fixation for treatment of cervical spondylotic myelopathy in large breed dogs. Vet Surg 2009; 38 (06) 705-718
• 15 Hettlich BF, Allen MJ, Glucksman GS, Fosgate GT, Litsky AS. Effect of an intervertebral disk spacer on stiffness after monocortical screw/polymethylmethacrylate fixation in simulated and cadaveric canine cervical vertebral columns. Vet Surg 2014; 43 (08) 988-994
• 16 Farrokhi MR, Torabinezhad S, Ghajar KA. Pilot study of a new acrylic cage in a dog cervical spine fusion model. J Spinal Disord Tech 2010; 23 (04) 272-277
• 17 Bergman RL, Levine JM, Coates JR, Bahr A, Hettlich BF, Kerwin SC. Cervical spinal locking plate in combination with cortical ring allograft for a one level fusion in dogs with cervical spondylotic myelopathy. Vet Surg 2008; 37 (06) 530-536
• 18 Steffen F, Voss K, Morgan JP. Distraction-fusion for caudal cervical spondylomyelopathy using an intervertebral cage and locking plates in 14 dogs. Vet Surg 2011; 40 (06) 743-752
• 19 Solano MA, Fitzpatrick N, Bertran J. Cervical distraction-stabilization using an intervertebral spacer screw and string-of-pearl (SOP™) plates in 16 dogs with disc-associated wobbler syndrome. Vet Surg 2015; 44 (05) 627-641
• 20 Rohner D, Kowaleski MP, Schwarz G, Forterre F. Short-term clinical and radiographical outcome after application of anchored intervertebral spacers in dogs with disc-associated cervical spondylomyelopathy. Vet Comp Orthop Traumatol 2019; 32 (02) 158-164
• 21 Bruecker KA, Seim HB, Blass CE. Caudal cervical spondylomyelopathy: decompression by linear traction and stabilization with Steinman pins and polymethyl methacrylate. J Am Anim Hosp Assoc 1989; 25: 677-683
• 22 Rusbridge C, Wheeler SJ, Torrington AM, Pead MJ, Carmichael S. Comparison of two surgical techniques for the management of cervical spondylomyelopathy in Dobermanns. J Small Anim Pract 1998; 39 (09) 425-431
• 23 McKee WM, Butterworth SJ, Scott HW. Management of cervical spondylopathy-associated intervertebral, disc protrusions using metal washers in 78 dogs. J Small Anim Pract 1999; 40 (10) 465-472
• 24 Joffe MR, Parr WCH, Tan C, Walsh WR, Brunel L. Development of a customized interbody fusion device for treatment of canine disc-associated cervical spondylomyelopathy. Vet Comp Orthop Traumatol 2019; 32 (01) 79-86
• 25 Reints Bok TE, Willemsen K, van Rijen MHP, Grinwis GCM, Tryfonidou MA, Meij BP. Instrumented cervical fusion in nine dogs with caudal cervical spondylomyelopathy. Vet Surg 2019; 48 (07) 1287-1298
• 26 Morrison EJ, Litsky AS, Allen MJ, Fosgate GT, Hettlich BF. Evaluation of three human cervical fusion implants for use in the canine cervical vertebral column. Vet Surg 2016; 45 (07) 901-908
• 27 Hasegawa K, Hirano T, Shimoda H, Homma T, Morita O. Indications for cervical pedicle screw instrumentation in nontraumatic lesions. Spine 2008; 33 (21) 2284-2289
• 28 Abumi K. Cervical spondylotic myelopathy: posterior decompression and pedicle screw fixation. Eur Spine J 2015; 24 (Suppl. 02) 186-196
• 29 Dunlap BJ, Karaikovic EE, Park HS, Sokolowski MJ, Zhang LQ. Load sharing properties of cervical pedicle screw-rod constructs versus lateral mass screw-rod constructs. Eur Spine J 2010; 19 (05) 803-808
• 30 Lewchalermwong P, Suwanna N, Meij BP. Canine vertebral screw and rod fixation system: design and mechanical testing. Vet Comp Orthop Traumatol 2018; 31 (02) 95-101
• 31 White III AA, Panjabi M. Kinematics of the spine. In: White III AA, Panjabi MM. eds. Clinical Biomechanics of the Spine. Philadelphia, PA: Lippincott; 1990: 85-125
• 32 Zindl C, Litsky AS, Fitzpatrick N, Allen MJ. Kinematic behavior of a novel pedicle screw-rod fixation system for the canine lumbosacral joint. Vet Surg 2018; 47 (01) 114-124
• 33 Corlazzoli D. Bicortical implant insertion in caudal cervical spondylomyelopathy: a computed tomography simulation in affected Doberman Pinschers. Vet Surg 2008; 37 (02) 178-185
• 34 Fransson BA, Zhu Q, Bagley RS, Tucker R, Oxland TR. Biomechanical evaluation of cervical intervertebral plug stabilization in an ovine model. Vet Surg 2007; 36 (05) 449-457
• 35 Breit S, Künzel W. Shape and orientation of articular facets of cervical vertebrae (C3-C7) in dogs denoting axial rotational ability: an osteological study. Eur J Morphol 2002; 40 (01) 43-51
• 36 Johnson JA, da Costa RC, Bhattacharya S, Goel V, Allen MJ. Kinematic motion patterns of the cranial and caudal canine cervical spine. Vet Surg 2011; 40 (06) 720-727
• 37 Koller H, Acosta F, Tauber M. et al. Cervical anterior transpedicular screw fixation (ATPS)–Part II. Accuracy of manual insertion and pull-out strength of ATPS. Eur Spine J 2008; 17 (04) 539-555
• 38 Fu M, Lin L, Kong X. et al. Construction and accuracy assessment of patient-specific biocompatible drill template for cervical anterior transpedicular screw (ATPS) insertion: an in vitro study. PLoS One 2013; 8 (01) e53580
• 39 Hamilton-Bennett SE, Oxley B, Behr S. Accuracy of a patient-specific 3D printed drill guide for placement of cervical transpedicular screws. Vet Surg 2018; 47 (02) 236-242
• 40 Hofstetter M, Gédet P, Doherr M, Ferguson SJ, Forterre F. Biomechanical analysis of the three-dimensional motion pattern of the canine cervical spine segment C4-C5. Vet Surg 2009; 38 (01) 49-58
• 41 Kolstad F, Nygaard ØP, Andresen H, Leivseth G. Anterior cervical arthrodesis using a “stand alone” cylindrical titanium cage: prospective analysis of radiographic parameters. Spine 2010; 35 (16) 1545-1550