The Use of Plastic Plates for Fixation of Spinal Fractures in the Dog

Plastic plates are a rapid and easy method to realign and stabilize the spinal column following a traumatic injury and may give greater bone-to-plate contact than metal plates. They distribute the pressure on the spinous processes over a larger surface area although plate slippage and spinous process fractures can occur as with any plate. Laminectomies should not be a routine procedure with plating but each patient should be evaluated individually and autogenous bone grafts may be used to advantage to promote fusion of vertebral bodies. In the two cases presented, the plastic plates achieved their purpose. However, it is essential that fusion of the vertebrae occurs before the plates slip or the spinous processes fracture.     

Fractures and luxations of the vertebral column.

External fixation of the vertebral column is indicated to treat fractures of the caudal lumbar spine, open fractures where vertebral osteomyelitis is present or likely to occur, and vertebral fractures not easily stabilized by internal fixation alone (e.g., compression fractures, fractures including spinous processes, and articular facets). Advantages of external fixation of caudal lumbar fractures, especially in combination with dorsal fixation devices, include the following: Fracture fixation does not preclude dorsal decompression; fixation devices need not be applied directly to the fractured vertebrae; and the combined technique provides dorsal and ventral vertebral fixation, which is more stable than dorsal fixation alone. Although external fixation is not applicable to all vertebral fracture/luxations in small animals, it provides additional points of fixation for rigid stability. Animals with vertebral fracture/luxations treated with an external fixation device have tolerated the external portion well. Development of additional applications for this method of vertebral fracture repair seems warranted.     

Repair of transverse process fractures of multiple lumbar vertebrae in an adult dairy cow

Objective: To report lumbar vertebrae transverse process fracture repair using a narrow 3.5 mm limited contact dynamic compression plate (LC‐DCP) in an adult dairy cow. Study Design: Case report. Animals: A 3‐year‐old Holstein cow. Methods: Under general anesthesia, fractured left transverse processes of lumbar vertebrae 2–4 were repaired using internal fixation. A narrow 3.5 mm LC‐DCP was contoured and secured to the spinous process and the transverse process of each fractured vertebra. Results: Fractured transverse processes of the lumbar vertebrae were successfully repaired and the cow discharged 10 days after surgery. At 10 months after surgery, the cow was declared reserved champion at a regional show. Conclusion: A paramedian approach and muscle splitting can be used to repair multiple lumbar transverse process fractures using internal fixation with an excellent cosmetic outcome.     

Combined Kirschner-Ehmer device and dorsal spinal plate fixation technique for caudal lumbar vertebral fractures in dogs

A new surgical technique was developed for the fixation of caudal lumbar vertebral fractures in dogs. The technique provides optimal stabilization, can be used in combination with dorsal decompression, and does not require an intact spinous process on the fractured vertebra or attachment of the fixation devices to the fractured vertebra. The fixation consists of a Kirschner-Ehmer device and dorsal spinal plates. After fracture healing, only mild sedation of the dog is needed to allow removal of the external hardware used in the fixation. The technique, its indications, and its use in 5 cases are described.     

CONGENITAL ABNORMALITIES OF THE VERTEBRAL COLUMN IN FERRETS

Vertebral column pathologies requiring surgical intervention have been described in pet ferrets, however little information is available on the normal vertebral formula and congenital variants in this species. The purpose of this retrospective study was to describe vertebral formulas and prevalence of congenital vertebral anomalies in a sample of pet ferrets. Radiographs of 172 pet ferrets (96 males and 76 females) were included in this retrospective study. In 143 ferrets (83.14%), five different formulas of the vertebral column were recorded with normal morphology of vertebrae (rib attachment included) but with a variable number of thoracic (Th), lumbar (L), and sacral (S) vertebrae. The number of cervical (C) vertebrae was constant in all examined animals. Observed vertebral formulas were C7/Th14/L6/S3 (51.74%), C7/Th14/L6/S4 (22.10%), C7/Th14/L7/S3 (6.98%), C7/Th15/L6/S3 (1.74%), and C7/Th15/L6/S4 (0.58%). Formula C7/Th14/L6/S4 was significantly more common in males than in females (P < 0.05). Congenital spinal abnormalities were found in 29 ferrets (16.86%), mostly localized in the thoracolumbar and lumbosacral regions. The cervical region was affected in only one case. Transitional vertebrae represented the most common congenital abnormalities (26 ferrets) in the thoracolumbar (13 ferrets) and lumbosacral regions (10 ferrets) or simultaneously in both regions (three ferrets). Other vertebral anomalies included block (two ferrets) and wedge vertebra (one ferret). Spina bifida was not detected. Findings from the current study indicated that vertebral formulas may vary in ferrets and congenital abnormalities are common. This should be taken into consideration for surgical planning.     

Effects of anatomic conformation on three-dimensional motion of the caudal lumbar and lumbosacral portions of the vertebral column of dogs

OBJECTIVE: To determine the association between the 3-dimensional (3-D) motion pattern of the caudal lumbar and lumbosacral portions of the canine vertebral column and the morphology of vertebrae, facet joints, and intervertebral disks. SAMPLE POPULATION: Vertebral columns of 9 German Shepherd Dogs and 16 dogs of other breeds with similar body weights and body conditions. PROCEDURE: Different morphometric parameters of the vertebral column were assessed by computed tomography (CT) and magnetic resonance imaging. Anatomic conformation and the 3-D motion pattern were compared, and correlation coefficients were calculated. RESULTS: Total range of motion for flexion and extension was mainly associated with the facet joint angle, the facet joint angle difference between levels of the vertebral column in the transverse plane on CT images, disk height, and lever arm length. CONCLUSIONS AND CLINICAL RELEVANCE: Motion is a complex process that is influenced by the entire 3-D conformation of the lumbar portion of the vertebral column. In vivo dynamic measurements of the 3-D motion pattern of the lumbar and lumbosacral portions of the vertebral column will be necessary to further assess biomechanics that could lead to disk degeneration in dogs.     

Congenital kyphosis secondary to lumbar vertebral hypoplasia causing paraparesis in a Friesian foal

A 5‐day‐old Friesian colt was presented with a history of severe bilateral pelvic limb weakness since birth. Clinical examination revealed a painful dorsal deviation of the spinous processes of the lumbar vertebrae, pelvic limb paraparesis and grade 4/5 ataxia. Radiographic examination revealed kyphosis due to hypoplasia and malformation of the 5 lumbar vertebrae present. At myelography performed immediately after euthanasia, dorsal deviation of the myelographic contrast column was demonstrated at the level of T18–L4 with suspected spinal cord compression noticeable at L1. There was no lateral deviation of the spinal cord or scoliosis of the vertebrae visible.     

Osteology and radiology of the vertebral column in the white-eared opossum (Didelphis albiventris)

The white-eared opossum present a higher roadkill number in Brazil, and the vertebral column is often affected when some type of trauma occurs. Thus, this study describes the osteology and radiology of the vertebral column in white-eared opossum to serve as a basis for support in the veterinary clinical care, since the casuistry of care of this marsupial has increased every year. Radiographs of the cervical (C), thoracic (T), lumbar (L), sacral (S) and caudal (Cd) segments of the vertebral column were taken in thirty-five white-eared opossums (Didelphis albiventris). Furthermore, ten opossums without evident vertebral acquired or congenital abnormalities at the radiographic study were selected for anatomical study. Osteology was correlated with the radiographic images. The use of radiographs allowed the identification of congenital and acquired vertebral changes, as well as the identification of anatomical structures, their distribution and morphology and the number of vertebrae. The vertebral formula varied in the white-eared opossum. In 27 of 35 white-eared opossums (77.2%) with normal vertebral morphology, three vertebral formulas were observed: C7/T13/L6/S2 (62.9%), C7/T13/L5/S2 (5.7%) and C7/T13/L7/S2 (8.6%). Most of the specimens presented 27 caudal vertebrae. The anticlinal vertebra was identified as T10 in 77.2% and T11 in 22.8% of opossums. Cervical block vertebra was observed in two animals and sacrocaudal block vertebra in one animal. The haemal arches could be seen from Cd3–Cd4 in 80% and Cd2–Cd3 in 20% of opossums. The white-eared opossum showed a slender vertebral column with a relatively short thoracic region, a relatively long lumbar region and a highly flexible lumbosacral transition, suggesting that this animal is a fast-running and agile opossum. Therefore, these findings may serve as a basis for further research and support the veterinary clinical care, since the casuistry of care for this marsupial has increased every year.     

Treatment of spinal fractures using Lubra plates. A retrospective clinical and radiological evaluation of 15 cases

The purpose of this retrospective study was to review the clinical use along with the short- and long-term outcome in patients treated with Lubra plates to stabilize spinal fracture and dislocations that were considered unstable at time of surgery according to the 'three compartment theory'. The data that were collected included breed, age, gender, body weight of the patients, cause of injury, neurological grade (pre- and postoperative), radiographic findings, surgical treatment, and clinical and radiological outcome. Thirteen dogs and two cats were included with thoracic (1 case), thoracolumbar (3 cases), midlumbar (5 cases) and caudal lumbar (6 cases) vertebral fractures. For stabilization, the small-sized (3 cases), medium-sized (6 cases), and large-sized (6 cases) Lubra plates were used. The clinical outcome was excellent in 10/15 patients, functional in 2/15 and poor in 3/15 with a median follow-up period of nine years (range 2 months to 12 years). The fractures eventually stabilized by ventral spondylosis. No implant failure was seen, however demineralization of the spinous processes necessitated implant removal in one case. Our results suggest that Lubra plating is an appropriate technique for thoracolumbar and lumbar vertebral fractures as well as luxations in dogs and cats. The prognosis for neurological recovery was excellent when the animal had a neurological grade of 3 and was not paralyzed.     

Investigations on the Postnatal Development of the Macroscopic Proportions and the Topographic Anatomy of the Feline Spinal Cord

The aim of this work was to investigate the postnatal development of the feline spinal cord. Our study showed that the main period of growth leading to the cervical and lumbar enlargements begins after birth and is completed at the age of 5–6 months. Comparing the relationship between the length of the spinal cord and the vertebral column, we found that in contrast to the adult cat, in the newborn cat, length, area and volume of segments show similar values along the spinal cord. This also applied to the length of the vertebrae. Due to a heterogeneous growth, not all segments of the spinal cord end up situated cranial to their corresponding vertebrae. As a consequence, the end of the conus medullaris is still located within the sacral canal in animals older than 2 months. These findings strongly propose that injections into the vertebral canal of the cat have to be performed caudal to the sacral vertebrae.     

Methodology and validity of assessing kinematics of the thoracolumbar vertebral column in horses on the basis of skin-fixated markers

OBJECTIVE: To determine the validity of using skin-fixated markers to assess kinematics of the thoracolumbar vertebral column in horses. ANIMALS: 5 Dutch Warmblood horses without abnormalities of the vertebral column. PROCEDURE: Kinematics of T6, T10, T13, T17, L1, L3, L5, S3, and both tuber coxae were determined by use of bone-fixated and skin-fixated markers. Three-dimensional coordinate data were collected while horses were walking and trotting on a treadmill. Angular motion patterns were calculated and compared on the basis of 2-dimensional analysis of data from skin-fixated markers and 3-dimensional analysis of data from bone-fixated markers. RESULTS: Flexion-extension of thoracolumbar vertebrae and axial rotation of the sacrum were satisfactorily determined at both the walk and trot, using skin-fixated markers. Data from skin-fixated markers were accurate for determining lateral bending at the walk in the midthoracic and lower lumbar portion of the vertebral column only. However, at the trot, data from skin-fixated markers were valid for determining lateral bending for all thoracolumbar vertebrae. CONCLUSIONS AND CLINICAL RELEVANCE: Caution should be taken when interpreting data obtained by use of skin-fixated markers on lateral bending motions during the walk in horses. For determination of other rotations at the walk and all rotations at the trot, use of skin-fixated markers allows valid calculations of kinematics of the vertebral column. Understanding to what extent movements of skin-fixated markers reflect true vertebral motion is a compulsory step in developing noninvasive methods for diagnosing abnormalities of the vertebral column and related musculature in horses.     

Spinal trauma. Pathophysiology and management of traumatic spinal injuries.

Spinal trauma can originate from internal or external sources. Injuries to the spinal cord can be classified as either concussive or compressive and concussive. The pathophysiologic events surrounding spinal cord injury include the primary injury (compression, concussion) and numerous secondary injury mechanisms (vascular, biochemical, electrolyte), which are mediated by excessive oxygen free radicles, neurotransmitter and electrolyte alterations in cell membrane permeability, excitotoxic amino acids, and various other biochemical factors that collectively result in reduced SCBF, ischemia, and eventual necrosis of the gray and white matter. Management of acute spinal cord injuries includes the use of a high-dose corticosteroid regimen within the initial 8 hours after trauma. Sodium prednisolone and methylprednisolone, at recommended doses, act as oxygen radical scavengers and are anti-inflammatory. Additional considerations are the stability of the vertebral column, other conditions associated with trauma (i.e., pneumothorax), and the presence or absence of spinal cord compression, which may warrant surgical therapy. Vertebral fractures or luxations can occur in any area of the spine but most commonly occur at the junction of mobile and immobile segments. Dorsal and dorsolateral surgical approaches are applicable to the lumbosacral and thoracolumbar spine and dorsal and ventral approaches to the cervical spine. Indications for surgical intervention include spinal cord compression and vertebral instability. Instability can be determined from the type of fracture, how many of the three compartments of the vertebrae are disrupted, and on occasion, by carefully positioned stress studies of fluoroscopy. Decompression (dorsal laminectomy, hemilaminectomy, or ventral cervical slot) is employed when compression of the spinal cord exists. The hemilaminectomy (unilateral or bilateral) causes less instability than dorsal laminectomy and therefore should be used when practical. The preferred approach for atlantoaxial subluxation is ventral, and the cross pinning, vertebral fusion technique is used for stabilization. Fracture luxations of C-2 are repaired with small plates on the ventral vertebral body. The thoracic and upper lumbar spine is stabilized with dorsal fixation techniques or combined dorsal spinal plate/vertebral body plate fixation. Several methods of fixation can be used with lower lumbar or lumbosacral fractures, including the modified segmental technique and the combined dorsal spinal plate/Kirschner-Ehmer technique.     

Sacrocaudal agenesis in a Korean native calf (Bos Taurus Coreanae)

A male deformed Korean native calf was examined macroscopically. The deformed calf had no caudal vertebral columns from 5th lumbar vertebra, sacrum and coccygeal vertebrae. The spinal cord was terminated in the vertebral foramen of the 3rd lumbar vertebra. The cervical vertebrae had scoliosis and the 3rd and 4th cervical vertebrae were fused. The 2nd and 3rd lumbar vertebrae were fused and the left and right transverse processes of the 4th lumbar vertebra articulated with ala of the ilium. The rectum was greatly expanded by the imperforate anus and a rectourethral fistula was formed between the rectum and urethra. The deformed calf was recorded as a first documentation of sacrocaudal agenesis confirmed in a Korean native calf.     

Management of vertebral column fractures in dogs and cats: 211 cases (1977-1985)

Hospital records and radiographs of 211 dogs and cats with vertebral column fractures or luxations evaluated at the University of Tennessee Veterinary Teaching Hospital between April 1977 and September 1985 were reviewed. After neurologic examination, status of the animal was graded on a scale of 1 to 8. Decision to treat each animal either medically or surgically was based on the extent and type of injury, neurologic signs, veterinarian's experience, and owner's wishes. After treatment, neurologic status was evaluated on the aforementioned scale and differences in the outcome of treatment were determined between surgically and medically treated groups, relative to initial neurologic status and location of the fracture. Surgically treated animals had pretreatment mean (+/- SD) neurologic status (3.71 +/- 1.35) that was slightly worse (P = 0.0079) than that of medically managed cases (5.16 +/- 1.48). Animals of the surgically treated group improved significantly (P = 0.0122) more than did those of the medically treated group but after treatment, significant differences in neurologic status were not evident between surgically (6.67 +/- 1.49) and medically (7.07 +/- 1.24) treated animals. Medically treated animals required substantially longer to reach optimal neurologic status, but the average hospital stay was nearly twice as long for the surgically treated animals (13.5 days), compared with those treated medically (7.1 days). Animals with thoracic vertebral fractures had mean neurologic status that was worse than that in animals with cervical vertebral fractures (P = 0.0109). After either medical or surgical treatment, neurologic status did not differ among animals with cervical, thoracic, or lumbar vertebral fractures.(ABSTRACT TRUNCATED AT 250 WORDS)     

Methyl-methacrylate and bone screw repair of seventh lumbar vertebral fracture-luxations in dogs

Fracture-luxations of the seventh lumbar vertebrae in two large dogs were stabilised with bone screws and methylmethacrylate. Screws inserted bilaterally into the bodies of the lumbar vertebrae and ilial wings were left protruding by about 2 cm, and embedded in methylmethacrylate bone cement. Implant failure occurred in one dog six days after surgery, necessitating a revision of the fixation. Fracture healing and return of normal ambulation ocurred in both dogs. Implants were removed in one dog because of screw loosening and discomfort.     

Extradural spinal liposarcoma in a dog.

An 8-year-old female Doberman Pinscher was examined because of progressive, asymmetric, ambulatory caudal paraparesis. Myelography revealed extradural left ventrolateral spinal cord compression over the first and second lumbar vertebral bodies. A left hemilaminectomy, extending from the thirteenth thoracic to the second lumbar vertebrae, was done, and an extradural mass was removed. The tumor was identified histologically as myxoid liposarcoma. The dog's neurologic function improved gradually after surgery; however, at 7 months after surgery, hind limb neurologic function deteriorated rapidly over a 5-week period, presumably because of local recurrence of the tumor. The dog was euthanatized; necropsy was not permitted.     

Total vertebrectomy for stabilisation of chronic spinal lumbar luxation in a paraplegic dog without nociception

An adult male crossbred dog was referred with a history of a road traffic accident that took place 1 month earlier. Neurological examination revealed paraplegia with absent nociception in the pelvic limbs. On epaxial palpation, significant curvature of the anatomical axis of the spine between the third and fourth lumbar vertebrae was observed, with the presence of a bone end almost piercing the dog's skin. Survey radiographs of the lumbar spine revealed severe dislocation between L3 and L4 vertebrae. During surgery, the spinal cord was not visible between the dislocated segments. Because of difficulties in reducing the lumbar luxation during surgery, vertebrectomy and vertebral shortening were performed. After alignment between vertebrae L3 and L5, eight cortical orthopaedic screws and bone cement were used for fixation. After 30 days, the dog started to use a wheelchair and was considered by its owner to have a good quality of life with no evidence of pain. To the authors’ knowledge, this is the first case of severe luxation treated by total vertebrectomy and spine shortening in a dog. This surgery can be considered as an option in the management of severe spine luxation when the spinal cord is physically transected.     

Back kinematics of healthy trotting horses during treadmill versus over ground locomotion

Reasons for performing study: Treadmill locomotion is frequently used for training of sport horses, for diagnostic purposes and for research. Identification of the possible biomechanical differences and similarities between the back movement during treadmill (T) and over ground (O) locomotion is essential for the correct interpretation of research results. Objectives: To compare the kinematics of the thoracolumbar vertebral column in treadmill and over ground locomotion in healthy horses. Methods: Six sound Dutch Warmblood horses trotted on a T and O during 10 s at their own preferred velocity (mean ± s.d. 3.6 ± 0.3 m/s T and 3.6 ± 0.1 m/s O), which was the same in both conditions. Kinematics of the vertebral column was captured by infrared cameras using reflective skin markers attached over the spinous processes of selected vertebrae and other locations. Flexion‐extension and lateral bending range of motion (ROM), angular motion pattern (AMP) and intravertebral pattern symmetry (IVPS) of 5 vertebral angles (T6‐T10‐T13, T10‐T13‐T17, T13‐T17‐L1, T17‐L1‐L3 and L1‐L3‐l5) were calculated. Neck angle, linear and temporal stride parameters and protraction‐retraction angles of the limbs were also calculated. Results: The vertical ROM (flexion‐extension) was similar in both conditions, but the horizontal ROM (lateral bending) of the lumbar angles T17‐L1‐L3 and L1‐L3‐L5 was less during T locomotion (mean ± s.d. difference of 1.8 ± 0.6 and 1.7 ± 0.9°, respectively, P>0.05). During O locomotion, the symmetry pattern of the lumbar vertebral angles was diminished from 0.9 to 0.7 (1 = 100% symmetry) indicating increased irregularity of the movement (P>0.05). No differences were found in the basic linear and temporal stride parameters and neck angle. Potential relevance: Vertebral kinematics during treadmill locomotion is not identical to over ground locomotion, but the differences are minor. During treadmill locomotion lumbar motion is less, and caution should be therefore taken when interpreting lumbar kinematics.     

Dorsal spinous process impingement syndrome ('kissing spine') in a cat: imaging appearance and surgical management

Spinal pain is an important clinical presentation in feline patients, but the underlying causes can often be difficult to elucidate. Dorsal spinous process impingement syndrome ('kissing spine' or in human patients 'Baastrup syndrome') is a significant cause of spinal pain in equine and human patients and radiographically is characterised by a close approximation of adjacent spinous processes with reactive bone sclerosis affecting these spinous processes. In this report we describe the first reported case of dorsal spinous process impingement syndrome in a cat causing spinal pain, and successful surgical management of the syndrome. The affected cat presented at 5 years of age for evaluation of a 7-month history of progressive thoracolumbar pain. Radiographs revealed close approximation of the dorsal spinous processes of the seventh, eighth and ninth thoracic vertebrae (T7, T8 and T9), with associated reactive bone sclerosis. Surgical resection of the T8 dorsal spinous process resulted in complete resolution of the clinical signs with no evidence of recurrence 9 months after surgery.     

Calcium hydroxylapatite deposition disease in a Great Dane Puppy

A 10-week-old male Great Dane Puppy was presented for sudden onset tetraataxia and severe paresis of the front legs. Mineral deposits were detected radiographically, at gross postmortem examination, and light microscopically between the vertebral arches of multiple cervical and lumbar vertebrae. These deposits were associated with the interarchial ligaments (ligamentia interarcualia), along the interfaces of the synovium and articular cartilage of multiple cervical, thoracic, and lumbar facets, on the dorsal aspect of several thoracic intervertebral discs, and at the insertion of muscles at the lateral aspect of several cervical and thoracic vertebral bodies. The mineral deposits were associated with a granulomatous inflammation and synovial fibrocartilaginous metaplasia and proliferation, which was focally exuberant. X-ray diffraction analyses of the mineral deposits revealed calcium hydroxylapatite as the major component. The clinical signs in this puppy were due to focal compression of the spinal cord by marked extraarticular ligament-associated fibrocartilaginous proliferation.