Three cases of idiopathic sterile pyogranulomatous inflammation of epidural fat in miniature dachshunds

Progressive ataxia and paralysis in three Miniature Dachshunds were found to be caused by idiopathic sterile pyogranulomatous inflammation of epidural fat between T5 and L4. All dogs were managed by hemilaminectomy and removal of epidural compressive material. Surgical findings and histopathological evaluation were necessary to diagnose epidural pyogranulomatous inflammation. A dog did not regain motor and sensor function after the surgery. Two dogs had exhibited improved neurological function after the surgery, but they recurred. Oral cyclosporine treatment was useful for their long remission. Idiopathic sterile pyogranulomatous inflammation of epidural fat can be considered to be a cause of thoracolumbar myelopathy in dogs.     

Vertebral stabilization using positively threaded profile pins and polymethylmethacrylate, with or without laminectomy, for spinal canal stenosis and vertebral instability caused by congenital thoracic vertebral anomalies

Objective— To describe diagnostic findings, surgical technique, and outcome in dogs with thoracic spinal canal stenosis and vertebral instability secondary to congenital vertebral anomalies.
Study Design— Retrospective clinical study.
Animals— Dogs (n=9) with thoracic spinal canal stenosis.
Methods— Medical records (1995–1996; 2000–2006) of 9 dogs with a myelographic diagnosis of spinal canal stenosis and/or vertebral instability secondary to congenital vertebral anomaly that were surgically managed by vertebral stabilization with or without laminectomy were reviewed. Data on pre- and postoperative neurologic status, diagnostic findings, surgical techniques, and outcomes were retrieved. Follow-up evaluations were performed at 1, 2, and 6 months. Long-term outcome was assessed by means of clinical examination or owner telephone interviews.
Results— Spinal cord compression was confirmed by myelography, and in 2 dogs, dynamic compression by stress myelography. Eight dogs regained the ability to ambulate postoperatively. One dog with a partial recovery regained voluntary movement but did not become ambulatory.
Conclusions— Spinal cord injury secondary to congenital vertebral anomaly may have a good outcome when treated by vertebral stabilization with or without laminectomy. Adequate stabilization of the vertebrae and improved neurologic outcome were achieved in most dogs.
Clinical Relevance— Vertebral stabilization using positively threaded profile pins and polymethylmethacrylate with or without laminectomy is an effective treatment for spinal canal stenosis and vertebral instability secondary to congenital thoracic vertebral anomalies.     

Spinal epidural empyema in seven dogs

OBJECTIVE: To characterize the clinical signs, diagnostic and surgical findings, and outcome in dogs with spinal epidural empyema (SEE). STUDY DESIGN: Retrospective study. ANIMALS: Seven dogs. METHODS: Dogs with SEE between 1992 and 2001 were identified from a computerized medical record system. Inclusion criteria were: neurologic examination, vertebral column radiographs, myelography, antimicrobial culture and susceptibility of material collected surgically from the vertebral canal, a definitive diagnosis of SEE confirmed by surgery, and microscopic examination of tissue from the vertebral canal. RESULTS: Common signs were lethargy, fever, anorexia, apparent spinal pain, and paraparesis/plegia. Common laboratory abnormalities were peripheral neutrophilia, and neutrophilic pleocytosis in cerebrospinal fluid (CSF). Three dogs had concurrent discospondylitis and 1 of these had vertebral luxation. On myelography, extradural spinal cord compression was focal (2 dogs), multifocal (3), or diffuse (2). Bacteria were isolated not from CSF but from blood, surgical site, pleural fluid, or urine in 6 dogs. Dogs were administered antibiotics and had surgical decompression by hemilaminectomy. Five dogs improved neurologically and had a good long-term outcome. Two dogs were euthanatized, 1 because of worsening of neurologic signs and pneumonia, and the other because of herniation of a cervical intervertebral disc 1 month postoperatively, unrelated to the SEE. CONCLUSION: Dogs with SEE may have a good outcome when treated by surgical decompression and antibiotic administration. CLINICAL RELEVANCE: SEE should be included in a list of possible causes for dogs with fever, apparent spinal pain, and myelopathy.     

Surgical treatment of lumbosacral foraminal stenosis using a lateral approach in twenty dogs with degenerative lumbosacral stenosis

Objectives— To describe clinical signs, magnetic resonance imaging (MRI) and surgical findings using a lateral approach to the lumbosacral intervertebral foramen and to evaluate clinical outcomes in dogs with or without concurrent dorsal decompression and annulectomy.
Study Design— Retrospective study.
Animals— Dogs (n=20) with degenerative lumbosacral stenosis (DLSS).
Methods— Medical records (2002–2006) of dogs that had lumbosacral lateral foraminotomy alone or in combination with dorsal decompression were reviewed. Degree of dysfunction was assessed separately for each pelvic limb; dogs with unilateral signs were included in group A, those with bilateral signs in group B. Retrieved data were: signalment, history, neurologic status on admission, 3 days, 6 weeks, and 6 months postoperatively, duration of clinical signs, results of MRI, surgical site(s), intraoperative findings, and outcome.
Results— Based on the clinical and MRI findings unilateral foraminotomy was performed in 8 dogs, bilateral foraminotomy in 1 dog, unilateral foraminotomy with concurrent dorsal decompression in 7 dogs, and bilateral foraminotomy with concomitant dorsal decompression in 4 dogs. Surgery confirmed the presence of foraminal stenosis in all dogs, with osteophyte formation and soft tissue proliferations being the most common lesions. Outcome was good to excellent in 19 dogs and poor in 1 dog. Mean follow-up was 15.2 months (range, 6–42 months).
Conclusion— Lateral foraminotomy addresses compressive lesions within exit and middle zones of the lumbosacral foramen.
Clinical Relevance— Successful surgical management of DLSS is dependent on recognition and correction of each of the compressive lesions within the lumbosacral junction.     

Laser-Doppler Measurements of Spinal Cord Blood Flow Changes During Hemilaminectomy in Chondrodystrophic Dogs with Disk Extrusion

Objectives— (1) To assess spinal cord blood flow (SCBF) during surgical treatment of disk extrusion in dogs and (2) to investigate associations between SCBF, clinical signs, presurgical MRI images, and 24-hour surgical outcome.
Study Design— Cohort study.
Animals— Chondrodystrophic dogs with thoracolumbar disk extrusion (n=12).
Methods— Diagnosis was based on clinical signs and MRI findings, and confirmed at surgery. Regional SCBF was measured intraoperatively by laser-Doppler flowmetry before, immediately after surgical spinal cord decompression, and after 15 minutes of lavaging the lesion. Care was taken to ensure a standardized surgical procedure to minimize factors that could influence measurement readings.
Results— A significant increase in intraoperative SCBF was found in all dogs (Wilcoxon's signed-rank test; P =.05) immediately after spinal cord decompression and after 15 minutes. Changes in SCBF were not associated with duration of clinical signs; initial or 24-hour neurologic status; or degree of spinal cord compression assessed by MRI.
Conclusion— SCBF increases immediately after spinal cord decompression in dogs with disk herniation; however, increased SCBF was not associated with a diminished 24-hour neurologic status.
Clinical Relevance— An increase in SCBF does not appear to be either associated with the degree of spinal cord compression or of a magnitude sufficient to outweigh the benefit of surgical decompression by resulting in clinically relevant changes in 24-hour outcome.     

Vertebral canal and spinal cord mensuration: a comparative study of its effect on lumbosacral myelography in the dachshund and German shepherd dog

One hundred noncontrast spinal radiographic studies followed by myelography were evaluated to compare vertebral canal size and spinal cord location and size in a chondrodystrophic breed (50 Dachshunds) with those variables in a nonchondrodystrophic breed (50 German Shepherd Dogs). Measurements were made of the sagittal diameter (height) of the vertebral canal, sagittal diameter (height) of the spinal cord, and transverse diameter (width) of the spinal cord in the lumbar and sacral regions. Differences were detected in the craniocaudal location of maximal vertebral canal height and maximal spinal cord height. The spinal cords in the Dachshunds terminated further caudally than those in the German Shepherd Dogs. Location of maximal spinal cord width was different between the breeds, consistent with the apparent, more caudal termination of the cord in the Dachshunds. The ratio of spinal cord to vetebral canal heights was notably greater in the Dachshunds than in the German Shepherd Dogs. These differences in vertebral canal and spinal cord mensuration may influence the choice of radiographic technique and its interpretation. Injection sites may be selected further cranially in German Shepherd Dogs (L4-5) than in Dachshunds (L5-6).     

COMPUTED TOMOGRAPHY IN THE EVALUATION OF CAUDAL CERVICAL SPONDYLOMYELOPATHY OF THE DOBERMAN PINSCHER

Caudal cervical spondylomyelopathy is a common neurologic disorder of Doberman pinschers which has a number of striking similarities to cervical spondylotic myelopathy in humans. Diagnosis of this human disease is facilitated considerably by the use of computed tomographic (CT) myelography. Sixteen Doberman pinscher dogs with caudal cervical spondylomyelopathy were studied by conventional myelography followed by CT myelography. A close correlation was noted between the CT myelographic appearance of the cervical spinal cord in these dogs, and that reported for human cervical spondylotic myelopathy. Five dogs had atrophy of the spinal cord, and in another there was an accumulation of contrast medium within the spinal cord. These features are often associated with a poor response to surgical decompression in humans with cervical spondylotic myelopathy. The CT examination provided information that could not be obtained by conventional myelography alone and should be considered as an additional diagnostic procedure in dogs with caudal cervical spondylomyelopathy.     

Thoracolumbar dorsolateral laminectomy with osteotomy of the spinous process in fourteen dogs

Objective— To describe outcome after an alternative unilateral approach to the thoracolumbar spine for dorsal laminectomy.
Study Design— Retrospective clinical study.
Animals— Dogs (n=14) with thoracolumbar spinal cord compression.
Methods— Thoracolumbar spinal cord compression was lateral (6 dogs), dorsal (4), and dorsolateral (4) caused by subarachnoid (7) and synovial cysts (2) and intradural-extramedullary neoplasia (5). All dogs were treated by dorsal laminectomy with osteotomy of the spinous process using a unilateral paramedian approach. The contralateral paraspinal muscles were not stripped from the spinous process and the osteoligamentous complexes were preserved. Retraction of the spinous process and muscles to the contralateral side resulted in complete visualization of the dorsal vertebral arch thereby allowing dorsal laminectomy to be performed.
Results— No technique complications occurred. Approximately 75% exposure of the spinal cord (dorsal and lateral compartments) was achieved providing adequate visualization and treatment of the lesions. Transient deterioration of neurologic state occurred in 5 dogs because of extensive spinal cord manipulation. At long-term follow-up, 6 dogs were normal, 6 had clinical improvement, and 2 were unchanged.
Conclusion— Dorsal laminectomy after osteotomy and retraction of the spinous process may be considered in canine patients with dorsal, dorsolateral, or lateral compression to facilitate adequate decompression of the spinal cord.
Clinical Significance— This surgical technique offers an alternative approach to the thoracolumbar spine and spinal cord by a modified dorsal laminectomy that preserves the paraspinal muscle integrity on the contralateral side.     

Cervical Spine Locking Plate Fixation for Treatment of Cervical Spondylotic Myelopathy in Large Breed Dogs

Objective— To describe indirect decompression by means of cervical spine locking plate (CSLP) fixation with vertebral distraction, discectomy, and cancellous block bone grafting in large breed dogs with single caudal cervical dynamic spondylotic lesions diagnosed by myelography with linear traction to the cervical spine, and contrast-enhanced computed tomography.
Study Design— Prospective clinical study.
Animals— Dogs (n=12) with caudal cervical spondylotic myelopathy because of a single dynamic, traction-responsive lesion.
Methods— Single, traction-responsive, caudal cervical spondylotic lesions were treated by vertebral distraction, discectomy, cancellous block bone grafting, and CSLP fixation. Follow-up was obtained by sequential recheck examination by the author or referring veterinarian or by telephone inquiries.
Results— Ten dogs had neurologic improvement after surgery. Indirect decompression by maintained distraction with cancellous block grafting and CSLP fixation was readily accomplished with less risk of blood loss or iatrogenic spinal cord injury than that associated with direct (ventral) decompression. There were no complications of graft intrusion, extrusion or subsidence, implant loosening, foraminal impingement, or end-plate failure. Two dogs that had satisfactory short-term recoveries developed clinical signs associated with adjacent segment disease and were euthanatized. At long-term follow-up, 8 dogs had satisfactory function, either a normal gait or one with slight to moderate proprioceptive deficits.
Conclusions— CSLP fixation with cancellous block interbody grafting is an effective and perhaps safer method of treating single-level, traction-responsive cervical spondylosis in large breed dogs.
Clinical Relevance— CSLP fixation with interbody bone grafting is a viable alternative to other techniques for treatment of single-level, traction-responsive cervical spondylosis.     

Incidence of contralateral versus ipsi-lateral neurological signs associated with lateralised Hansen type I disc extrusion

Asymmetrical neurological signs were noted in 50 dogs presenting with Hansen type I thoracolumbar disc extrusion. Thoracolumbar myelograms and surgical decompression were performed in all cases. Dogs were divided into two groups (acute and chronic) based on the duration of clinical signs prior to presentation to the University of Georgia. Lateralising extradural cord compressive lesions were noted on all myelograms. In the acute group, 35 per cent of the dogs had asymmetrical neurological signs contralateral to the myelographic and surgical lesion, while in the chronic group only 11 per cent had neurological signs contralateral to the lesion. There was found to be no significant difference in frequency of contralateral asymmetrical clinical signs between the two groups (Fischer's exact test; P = 0–095). The high frequency of contralateral signs documents the importance of thoracolumbar myelography for accurate localisation of the disc material before decompressive surgery.     

Fecal incontinence associated with epidural spinal hematoma and intervertebral disk extrusion in a dog

CASE DESCRIPTION: A 7-year-old castrated male Great Dane was evaluated because of a 2-month history of fecal incontinence. CLINICAL FINDINGS: On the basis of the presence of paraparesis and apparently normal spinal reflexes, the neurologic signs were localized in the region of the third thoracic to the third lumbar spinal cord segments. On the basis of the findings of magnetic resonance imaging, a presumptive diagnosis of a compressive intervertebral disk extrusion with secondary hemorrhage and epidural hematoma formation was made. TREATMENT AND OUTCOME: A right-sided hemil-aminectomy was performed (centered at the T13-L1 intervertebral space) to further characterize the lesion and decompress the spinal cord. The histopathologic diagnosis was extruded intervertebral disk material with chronic hemorrhage and inflammation. Three weeks after surgery, there was complete resolution of the dog's fecal incontinence and moderate improvements in its hind limb function. CLINICAL RELEVANCE: Thoracolumbar spinal cord injuries can result in upper motor neuron fecal incontinence in ambulatory dogs. Epidural spinal hematomas may develop secondary to intervertebral disk herniations and cause spinal cord compression resulting in neurologic deficits.     

A method for intervertebral space distraction before stabilization combined with complete ventral slot for treatment of disc-associated wobbler syndrome in dogs

Objective— To evaluate the use of a modified K-wire spacer for maintaining intervertebral distraction after ventral decompression and during stabilization as a treatment for disc-associated wobbler syndrome in large breed dogs.
Study Design— A retrospective study.
Animals— Dogs (n=7) with disc-associated wobbler syndrome.
Methods— Medical records (2003–2006) of dogs treated by a modified surgical method were evaluated. Data retrieved were signalment, onset and duration of clinical signs, neurologic abnormalities, diagnostic methods, surgical procedure, immediate, and long-term (≥1 year) postoperative clinical and radiographic outcome.
Results— Mean duration of clinical signs was 4.8 months. Neurologic signs included ataxia (2), ambulatory tetraparesis (2), and non-ambulatory tetraparesis (3). Three dogs had disc protrusion in 2 sites, 2 dogs had the procedure in 1 location and stabilization of both affected sites. All dogs improved dramatically and remained for 1–3 years. One dog had recurrence of cervical discomfort 13 months later.
Conclusions— Despite the limited number of dogs, overall initial successful outcome with only 1 dog having mild recurrence 13 months later supports further use and evaluation of this technique.
Clinical Relevance— Distraction using a K-wire spacer after ventral decompression followed by stabilization should be considered in dogs with disc-associated wobbler syndrome to prevent collapse of the intervertebral space.     

Oxytocin Content of the Cerebrospinal Fluid of Dogs and Its Relationship to Pain Induced by Spinal Cord Compression

Objectives —To determine whether oxytocin exists in the cerebrospinal fluid (CSF) of dogs and whether the amount of oxytocin in the CSF of dogs with neck or back pain caused by spinal cord compression is significantly different than that in the CSF of clinically normal dogs.
Study Design —Prospective controlled study.
Animal Population —A total of 15 purpose-bred beagles and 17 client-owned dogs.
Methods —CSF was collected by needle puncture of the cerebellar medullary cistern after induction of general anesthesia. Oxytocin levels within the samples were determined through radioimmunoassay.
Results —Dogs with spinal cord compression had significantly more oxytocin in their CSF than the clinically normal dogs (13.76 ± 2.0 pg/mL and 3.61 ± 0.63 pg/mL, respectively; P < .0001). Dogs with chronic signs (>7 days) had significantly more oxytocin in their CSF than dogs with acute signs (<7 days) (21.60 ± 0.86 pg/mL and 6.80 ± 0.81 pg/mL, respectively; P < .0001). Both acutely and chronically affected dogs had significantly more oxytocin in their CSF than the controls ( P < .005 and P < .0001 respectively).
Conclusions —Dogs with neck and back pain caused by spinal cord compression have significantly more oxytocin in their CSF than clinically normal dogs. Dogs with chronic clinical signs have significantly more oxytocin in their CSF than dogs with acute clinical signs.
Clinical Relevance —In humans, intrathecal injection of oxytocin is effective in treating low back pain for up to 5 hours. Intrathecal oxytocin may be a logical choice for perioperative analgesia in dogs undergoing myelography because the intrathecal space is accessed for injection of contrast agent.     

Contrast-enhanced CT for localizing compressive thoracolumbar intervertebral disc extrusion

Thoracolumbar intervertebral disc extrusion is a common disease in dogs. Surgical decompression of the spinal cord is the preferred treatment. Localization of the compressive material is critical for surgical planning. Myelography has been used for localizing extruded disc material, but this procedure carries risk of complications. Computed tomography (CT) is becoming more available for use in veterinary medicine and CT myelography is used for localization of extruded disc material. This report compares CT with intravenous contrast medium and CT myelography for identifying extruded intervertebral discs. CT with intravenous contrast medium is as effective as CT myelography for determining level and laterality of compressive disc extrusions.     

The clinical, cerebrospinal fluid, and histopathologic effects of epidural ketorolac in dogs

OBJECTIVE: To evaluate the clinical, cerebrospinal fluid (CSF), and histopathologic effects of epidural ketorolac. STUDY DESIGN: Blinded, randomized, placebo controlled study. ANIMALS: Twenty-two adult mixed breed dogs with 16 treatment and 6 control dogs, weighing 14.4 to 29.8 kg. METHODS: Dogs were anesthetized and epidural catheters were placed at the lumbosacral space. Catheter placement was evaluated fluoroscopically. Ketorolac (0.4 mg/kg) or placebo (5% ethanol) was administered epidurally over a 52-hour period, with 5 injections given at 12-hour intervals. At 1, 2, 4, or 8 hours after the first and last injection of ketorolac, dogs were anesthetized and CSF was obtained. Control dogs had CSF sampled 1 hour after the first and last ethanol injection. Neurologic function and pain responses were evaluated before and during the study. Selected dogs were then killed and necropsies performed. RESULTS: None of the dogs exhibited any clinical or neurologic abnormalities during the study. No statistical difference was noted in pain response or CSF analysis between treatment and control dogs. Gross necropsy revealed gastrointestinal ulceration of varying degrees in all treatment dogs. Histopathologic analysis of the spinal cord and meninges revealed minimal focal leptomeningeal phlebitis in 2 of 8 treatment dogs and minor subdural inflammation in 1 control dog. No changes to the neural structures were noted in any dogs. CONCLUSIONS: Epidural administration of ketorolac did not cause clinical signs, alteration in CSF values, or pathologic changes to the spinal cord when used for short duration. Gastrointestinal ulceration was common when ketorolac was administered epidurally at 0.4 mg/kg every 12 hours for 5 treatments. CLINICAL RELEVANCE: This study documented the neurologic safety of epidural ketorolac in dogs before an efficacy trial can be performed. Gastrointestinal ulceration may limit use to short duration or a single injection.     

Clinical presentation,diagnosis, treatment and outcome of spinal epidural empyema in four cats (2010 to 2016)

This case series reviews previous publications and reports four feline spinal epidural empyema cases that presented with non-ambulatory thoracolumbar myelopathy. Two cats underwent myelography and two MRI. Bacteria were obtained in three cases, in two from epidural abscesses and from a tail base wound in one; histopathological examination of epidural tissue showed pyogranulomatous changes in the remaining cat. Three cats were treated by surgical decompression plus antimicrobial therapy and one cat was treated medically. All cats showed satisfactory improvement following treatment over a follow-up period of 3 months. Spinal epidural empyema is a rare condition but all cats in this series had favourable outcomes.     

Clinical improvement in two dogs with hydrocephalus and syringohydromyelia after ventriculoperitoneal shunting

Two young Miniature Dachshunds were presented with abnormal gait. Magnetic resonance imaging showed, hydrocephalus with expanding fourth ventricle, and syringohydromyelia in the cervical spinal cord. These dogs underwent ventricle-peritoneal shunting, after which hydrocephalus, syringohydromyelia, and their clinical signs, improved.     

Fibrocartilaginous Embolism of the Spinal Cord in Dogs: Review of 36 Histologically Confirmed Cases and Retrospective Study of 26 Suspected Cases

Clinical features of 36 dogs with histologically confirmed fibrocartilaginous embolism (FCE) were contrasted with those of 26 dogs in which FCE was suspected based on characteristic clinical findings and the absence of compressive spinal cord disease on myelography. Dogs with confirmed and suspected FCE were of similar signalment, and had acute, nonprogressive dysfunction, often associated with trauma or exercise. The "suspected" group included fewer giant breeds and more often had asymmetric lesions, intact nociception, and upper motor neuron involvement. Dog size and severity of clinical signs probably contributed to owners choosing euthanasia in dogs with confirmed lesions. Accordingly, data from such patients may be skewed relative to these clinical features. J Vet Intern Med 1996;10:241–245. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

RADIOGRAPHIC AND MYELOGRAPHIC EXAMINATION OF THE CERVICAL VERTEBRAL COLUMN IN 306 ATAXIC HORSES

This study consists of a review of 306 ataxic horses subjected to survey radiography and myelography of the cervical vertebral column. Fifty-eight percent of horses had evidence of compressive spinal cord lesion on myelography. Sixty-six percent of horses were less than 3 years old. Age had no effect on the distribution of spinal cord compressive lesions. No conclusion could be drawn from sex and breed distribution. The most common sites of cord compression on myelography in order of decreasing frequency were C_3–4, C_6–7, C_5–6, and C_4–5. Twenty-nine percent of horses with myelographic evidence of cord compression had multiple compressive sites. Survey radiographs were not reliable to diagnose compressive spinal cord lesions. Myelography was a safe and more accurate procedure. Several factors may result in misinterpretation of the myelographic examination.     

Closed fluoroscopic-assisted spinal arch external skeletal fixation for the stabilization of vertebral column injuries in five dogs

Objective— To evaluate outcome after closed fluoroscopic-assisted application of spinal arch external skeletal fixators in dogs with vertebral column injuries.
Study Design— Retrospective case series.
Animals— Dogs with traumatic vertebral column injuries (n=5).
Methods— Medical records of dogs with vertebral column fractures and/or luxations stabilized with spinal arch external skeletal fixator frames applied using a closed fluoroscopic-assisted technique were reviewed. Owners were contacted to obtain long-term clinical outcomes.
Results— Five dogs (age range, 6–72 months; weight, 10–54 kg) had traumatic vertebral column injuries stabilized with spinal arch external skeletal fixators applied in closed fashion. Injuries involved vertebral segments of the thoracolumbar junction, lumbar spine, and lumbosacral junction. Immediately postoperatively, 4 dogs had anatomic alignment of their vertebral fracture/luxation; 1 dog had 1 mm of vertebral canal height compromise. Time to fixator removal ranged from 65 to 282 days (141±87 days). All dogs had regained satisfactory neurologic function by 3 months. At long-term follow-up (range, 282–780 days; mean 445±190 days) all dogs were judged to have good to excellent return of function by their owners.
Conclusion— Successful closed fluoroscopic-assisted application of external skeletal fixators using spinal arches provided satisfactory reduction with few complications in 5 dogs. Return to function was judged to be good to excellent in all dogs at long-term evaluation.
Clinical Relevance— Closed fluoroscopic-assisted application of ESF using spinal arches provided satisfactory reduction and effective stabilization of spinal fractures with few complications and should be considered as a treatment approach.