Treatment of lumbosacral discospondylitis by surgical stabilisation and application of a gentamicin-impregnated collagen sponge

A. I. C. Renwick; R. Dennis; T. J. Gemmill

doi:10.3415/VCOT-09-12-0124

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2010; 23(04): 266-272
DOI: 10.3415/VCOT-09-12-0124

Case Report

Schattauer GmbH

Treatment of lumbosacral discospondylitis by surgical stabilisation and application of a gentamicin-impregnated collagen sponge

A. I. C. Renwick

¹Willows Referral Service, Shirley, Solihull, UK

,

R. Dennis

²Centre for Small Animal Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk, UK

,

T. J. Gemmill

¹Willows Referral Service, Shirley, Solihull, UK

› Author Affiliations

Abstract

Summary

This report describes a case of lumbosacral discospondylitis in a two-year-old boxer dog. The dog had been presented with chronic hindlimb lameness and signs of lumbar spinal pain. The diagnosis was confirmed with a magnetic resonance imaging scan and positive blood culture. Following unsuccessful conservative management, the dog was treated with surgical stabilisation using screws and polymethylmethacrylate, and implantation of a gentamicin-impregnated collagen sponge into the L7-S1 disc space. This technique has not previously been described. The dog had a successful long-term outcome with complete resolution of clinical signs

Keywords

Discospondylitis - dog - gentamicin - lumbosacral stabilisation - magnetic resonance imaging

Full Text

References

References
1 Auger J, Dupuis J, Quesnel A. et al. Surgical treatment of lumbosacral instability caused by discospondylitis in four dogs. Vet Surg 2000; 29: 70-80.
2 Burkert BA, Kerwin SC, Hosgood GL. et al. Signalment and clinical features of diskospondylitis in dogs: 513 cases (1980–2001). J Am Vet Med Assoc 2005; 227: 268-275.
3 Watt PR, Robins GM, Galloway AM. et al. Disseminated opportunistic fungal disease in dogs: 10 cases (1982–1990). J Am Vet Med Assoc 1995; 207: 67-70.
4 Butterworth S, Barr F, Pearson G. et al. Multiple discospondylitis associated with Aspergillus species infection in a dog. Vet Rec 1995; 136: 38-41.
5 Sharp NJH, Wheeler SJ. Miscellaneous conditions. In Sharp NJH, Wheeler SJ. editors. Small Animal Spinal Disorders Diagnosis and Surgery. Philadelphia: Elsevier Mosby; 2005. p 319-337.
6 Dewey CW, Coates JR. Miscellaneous Spinal Conditions and Peripheral Nerve Injuries. In Slatter D. editor. Textbook of Small Animal Surgery. Philadelphia, Pennsylvania: Saunders; 2003. p 1209-1218.
7 Gilmore DR. Lumbosacral diskospondylitis in 21 dogs. J Am Anim Hosp Assoc 1987; 23: 57-61.
8 Turnwald GH, Shires PK, Turk MA. et al. Diskospondylitis in a kennel of dogs: clinicopathologic findings. J Am Vet Med Assoc 1986; 188: 178-183.
9 Hediger KU, Ferguson SJ, Gedet P. et al. Biomechanical analysis of torsion and shear forces in lumbar and lumbosacral spine segments of nonchondrodystrophic dogs. Vet Surg 2009; 38: 874-880.
10 Benninger MI, Seiler GS, Robinson LE. et al. Three-dimensional motion pattern of the caudal lumbar and lumbosacral portions of the vertebral column of dogs. Am J Vet Res 2004; 65: 544-551.
11 McKee WM, Mitten RW, Labuc RH. Surgical treatment of lumbosacral discospondylitis by a distraction-fusion technique. J Small Anim Pract 1990; 31: 15-20.
12 Beaver DP, MacPherson GC, Muir P. et al. Methylmethacrylate and bone screw repair of seventh lumbar vertebral fracture-luxations in dogs. J Small Anim Pract 1996; 37: 381-386.
13 Cariou MP, Stork CK, Petite AF. et al. Cauda equina syndrome treated by lumbosacral stabilisation in a cat. Vet Comp Orthop Traumatol 2008; 21: 462-466.
14 Rohde V, Meyer B, Schaller C. et al. Spondylodiscitis after lumbar discectomy. Incidence and a proposal for prophylaxis. Spine (Phila Pa 1976) 1998; 23: 615-620.
15 Piermattei DJ, Johnson KA. An atlas of surgical approaches to bones and joints of the dog and cat. St. Louis, Missouri: Elsevier Saunders; 2006
16 Sharp NJH, Wheeler SJ. Lumbosacral Disease. Small Animal Spinal Disorders Diagnosis and Surgery. Philadelphia: Elsevier Mosby; 2005. p 181-209.
17 Shamir MH, Tavor N, Aizenberg T. Radiographic findings during recovery from discospondylitis. Vet Radiol Ultrasound 2001; 42: 496-503.
18 Sobottke R, Seifert H, Fatkenheuer G. et al. Current diagnosis and treatment of spondylodiscitis. Dtsch Arztebl Int 2008; 105: 181-187.
19 Honan M, White GW, Eisenberg GM. Spontaneous infectious discitis in adults. Am J Med 1996; 100: 85-89.
20 Gonzalo-Orden JM, Altónaga JR, Orden MA. et al. Magnetic resonance, computed tomographic and radiologic findings in a dog with discospondylitis. Vet Radiol Ultrasound 2000; 41: 142-144.
21 Ozuna RM, Delamarter RB. Pyogenic vertebral osteomyelitis and postsurgical disc space infections. Orthop Clin North Am 1996; 7: 87-94.
22 Dai LY, Chen WH, Jiang LS. Anterior instrumentation for the treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine. Eur Spine J 2008; 17: 1027-1034.
23 Eysel P, Hopf C, Vogel I. et al. Primary stable anterior instrumentation or dorsoventral spondylodesis in spondylodiscitis? Results of a comparative study. Eur Spine J 1997; 6: 152-157.
24 Jeanneret B, Magerl F. Treatment of osteomyelitis of the spine using percutaneous suction/irrigation and percutaneous external spinal fixation. J Spinal Disord 1994; 7: 185-205.
25 Rath SA, Neff U, Schneider O. et al. Neurosurgical management of thoracic and lumbar vertebral osteomyelitis and discitis in adults: a review of 43 consecutive surgically treated patients. Neurosurgery 1996; 38: 926-933.
26 Watine S, Cabassu JP, Catheland S. et al. Computed tomography study of implantation corridors in canine vertebrae. J Small Anim Pract 2006; 47: 651-657.
27 Meij BP, Suwankong N, Van der Veen AJ. et al. Bio-mechanical flexion-extension forces in normal canine lumbosacral cadaver specimens before and after dorsal laminectomy-discectomy and pedicle screw-rod fixation. Vet Surg 2007; 36: 742-751.
28 Cabassu J, Moissonnier P. Surgical treatment of a vertebral fracture associated with a haematogenous osteomyelitis in a dog. Vet Comp Orthop Traumatol 2007; 20: 227-230.
29 Cho SH, Song HR, Koo KH. et al. Antibiotic-impregnated cement beads in the treatment of chronic osteomyelitis. Bull Hosp Jt Dis 1997; 56: 140-144.
30 Ruszczak Z, Friess W. Collagen as a carrier for on-site delivery of antibacterial drugs. Adv Drug Deliv Rev 2003; 55: 1679-1698.