Effect of Disk Fenestration on Sagittal Kinematics of the Canine C5-C6 Intervertebral Space

OBJECTIVE: To determine the effect that ventral intervertebral disk fenestration has on the sagittal range of motion about the C5-C6 intervertebral space. STUDY DESIGN: A repeated measures in vitro mechanical study of spinal range of motion under controlled loading conditions before and after fenestration. SAMPLE POPULATION: A total of 10 canine cervical vertebral specimens (C4-C7) collected from clinically normal animals within 12 hours of euthanasia. METHODS: Specimens were loaded as cantilever beams fixed at C7. Weights (1 to 5 kg) were progressively applied to C4 to produce flexion or extension in the sagittal plane. Radiographs were taken at each load, 3 times before and 3 times after fenestration of the C5-C6 disk. The positions of radiodense markers embedded in the vertebrae were used to calculate flexion and extension angles and range of motion. RESULTS: Range of motion (difference between flexion and extension) and flexion and extension angles (individually) significantly increased after fenestration (P < .0001). CONCLUSION: Ventral fenestration produces sagittal instability of the C5-C6 disk space. CLINICAL RELEVANCE: In surgical fusion of caudal cervical intervertebral spaces in dogs, radiographically normal disks adjacent to the affected space are often fenestrated to facilitate distraction before surgical stabilization. This study shows that ventral fenestration produces instability of a caudal cervical intervertebral space in the model used. Such instability may contribute to the development of the secondary instability ("domino lesions") seen in some surgically treated dogs.     

Kinematics of the equine thoracolumbar spine

At least three types of movement take place in the joint complexes of the equine thoracolumbar spine: dorsoventral flexion and extension, axial rotation and lateral bending. Using the standard right-handed Cartesian coordinate system, these movements may be defined as rotation about the x, y and z axes respectively. Except in cases of intervertebral fusion, all three types of movement occur in each joint complex of the equine back. The greatest amount of dorsoventral movement takes place at the lumbosacral and the first thoracic intervertebral joints. The greatest amount of axial rotation and lateral bending was measured in the mid-thoracolumbar spine at the level of the 11th or 12th thoracic intervertebral joints. The caudal thoracic and the lumbar spine is the least mobile region of the equine back. In the mid-thoracic spine, lateral bending was always accompanied by a "coupled" axial rotation. The presence of the rib cage stabilised the cranial thoracic vertebrae against axial rotation.     

Kinematics of the cervical spine of the adult horse

At least three types of movement, dorsoventral flexion and extension, axial rotation and lateral bending, were shown to occur at each of the intervertebral joints in the cervical spine. Between the first two cervical vertebrae the mean axial rotation was 107.5 degrees, which was 73 per cent of the total axial rotation of the cervical spine. The atlantooccipital joint rotated through a mean of 27 degrees, whereas the remaining cervical joints each had less than 3 degrees of rotatory movement. Dorsoventral flexion and extension were maximal at the atlantooccipital joint, which had an amplitude of 86.4 degrees and accounted for 32 per cent of the total dorsoventral movement of the cervical spine. Lateral bending was relatively more uniform along the length of the neck, with mean values ranging from 25 to 45 degrees for each joint except that between the first two cervical vertebrae, which had a mean of only 3.9 degrees of lateral bending.     

Kinematic Motion Patterns of the Cranial and Caudal Canine Cervical Spine

Objective: To define the kinematic motion patterns of the canine cervical spine, with a particular emphasis on identifying differences between the cranial (C₂–C₄) and caudal (C₅–C₇) segments, and to determine the significance of coupled motions (CM) in the canine cervical spine. Study Design: Cadaveric biomechanical study. Sample Population: Cervical spines of 8 Foxhounds. Methods: Spinal specimens were considered free of pathology based on radiographic, computed tomography, and magnetic resonance imaging examinations. All musculature was removed without damaging ligaments or joint capsules. Spines were mounted in a customized pure‐moment spine testing jig, and data were collected using an optoelectronic motion capture system. Range of motion, neutral zone and CM in flexion/extension, left/right lateral bending and left/right axial rotation were established. Data were analyzed using mixed‐effects maximum likelihood regression models. Results: Total flexion/extension did not change across the 4 levels. There was no difference between flexion and extension, and no CM was identified. Lateral bending was not different across levels, but tended to be greater in the cranial spine. Axial rotation was ～2.6 times greater in the caudal segments. Lateral bending and axial rotation were coupled. Conclusions: Kinematics of the cranial and caudal cervical spine differed markedly with greater mobility in the caudal cervical spine.     

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.     

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

Objective— To compare the biomechanical properties of cervical arthroplasty to a ventral slot procedure and pin‐polymethylmethacrylate (pin‐PMMA) fixation. Sample Population— Fresh cadaveric cervical (C2–T1) spines from 6 large dogs. Methods— Four spinal conditions were studied in each spinal specimen: intact, disk arthroplasty, ventral slot, and fixation with smooth pin‐PMMA at C5–C6 intervertebral space. Axial compression, torsion, flexion–extension, and lateral bending moments were sequentially tested on each specimen for the 4 spinal conditions. Data from the C3–C4, C4–C5, C5–C6, and C6–C7 vertebral motion units (VMUs) were compared among treatments. Results— In axial compression and torsion, the ventral slot procedure allowed significantly less motion than intact, pin‐PMMA, and arthroplasty groups at C5–C6. In lateral bending and flexion–extension, pin‐PMMA had the least motion of C5–C6, followed by the arthroplasty group, intact spine, and ventral slot, all of which were significantly different from each other. Overall, the artificial disk was better able to mimic the behavior of the intact specimens compared with the ventral slot and pin‐PMMA, producing similar displacements in axial compression and rotation in torsion, but more limited motion than intact in flexion–extension and in lateral bending. Conclusion— Cervical spine specimens with an implanted prosthesis have biomechanical behaviors more similar to an intact spine compared with spinal specimens with ventral slot and pin‐PMMA procedures. Cervical arthroplasty may then preserve some of the motion in the affected area after neural decompression while providing distraction. Clinical Relevance— Cervical arthroplasty should be further investigated in vivo to determine if it is a viable alternative to the ventral slot or pin‐PMMA procedures for surgical treatment of cervical diseases in dogs and in particular for treatment of disk‐associated caudal cervical spondylomyelopathy.     

Location of the instantaneous center of joint rotation in the normal canine stifle

Locations of 3 instantaneous centers of joint rotation (ICR) were found in the stifles of 6 healthy dogs. A novel algorithm, verified by computer simulation, was used to determine ICR from radiographs. Comparisons of ICR locations were made between flexion and extension, between left and right limbs, and between living and dead dogs, using analysis of variance. All stifles were examined for evidence of lesions, but all were normal. The normal location of the ICR in the stifle is near the joint surface, indicating that there is a predominantly rolling type of motion. As the limb flexes, the ICR moves caudally; as the limb extends, the ICR moves cranially. Significant differences in ICR position were not found between left and right limbs or between living and dead dogs. The average ICR position was significantly more caudal during extension than it was during flexion. Knowing the normal ICR position is a preliminary to diagnosing joint abnormalities, using the ICR.     

Endotracheal Tube Displacement During Cervical Manipulation in the Dog

A retrospective study was performed to identify positional changes of endotracheat tubes (ETT) during cervical spine radiography in 153 dogs. Three neck positions were identified: traction, hyperextension, and flexion. A properly placed ETT was defined as having the caudal tip of the tube located between the caudal half of the fourth cervical (C) vertebra (C₄) and the caudal half of C₇. In the traction position, before neck flexion and extension, the caudal tip of 13% of ETT were located caudal to C₇, and one tube was in the endobronchial position at the seventh thoracic (T) vertebra (T₇). In the hyperextended position, 60% of ETT moved cranially. The average distance moved was 0.6 vertebral spaces. In the flexed position, all ETT moved caudally. The average distance moved was 3.5 vertebral spaces, with 81.8% of ETT located caudal to C₇ and seven tubes in endobronchial positions. Endotracheal tube occlusion caused by kinking at the atlanto-occipital joint was seen in four dogs during flexion of the neck. Based on this study, ETT position should be monitored during cervical manipulation.     

A morphometric investigation on breed-specific features affecting sagittal rotational and lateral bending mobility in the canine cervical spine (c3-c7)

Vertebral and inter-vertebral parameters obtained in large breeds (n = 74), small breeds (n = 35), and Dachshunds (n = 30) were compared to reveal potential differences in the range of motion of the cervical spine between these three groups of breeds. Body size normalized dimensions of vertebral and inter-vertebral parameters and correlations between these indicate large canine breeds to have a tendency towards higher range of motion in sagittal rotation and lateral bending compared with Dachshunds and small breeds. Higher mobility in large breeds is based on significantly (P < 0.05) lower vertebral endplate heights and widths, shorter vertebral bodies and longer inter-vertebral discs, wider but shorter cranial and caudal articular surfaces, larger differences in width between caudal and cranial joining facets (compared with Dachshunds from C3/4 to C6/7, compared with small breeds from C4/5 to C5/6), and larger differences in length between caudal and cranial joining facets. Large differences in width between caudal and cranial joining facets were associated with small distances between the most medial (C3/4 to C6/7) and lateral (C3/4 to C5/6) aspects of the articular surfaces as well as with small differences in length between caudal and cranial joining facets (C3/4 to C5/6). This suggests that from C3/4 to C5/6 a higher range of motion in lateral bending is coupled to a lower range of motion in sagittal rotation. The present findings contribute also to explain the higher incidence of degenerative lesions of the cervical spine in large dogs.     

Vertebral stabilisation for cervical spondylopathy using a screw and washer technique

A transvertebral screw and interbody washer technique was used to stabilise the vertebrae and maintain the intervertebral space in 34 adult dobermann pinschers with cervical spondylopathy. The long term success of the procedure was 50 per cent. Pre-operatively three dogs were considered mildly ataxic, 16 moderately ataxic, 13 severely ataxic and two non-ambulatory. Thirty dogs had radiographic changes of calcified disc, vertebral malalignment or narrow intervertebral disc space and all dogs had myelographic abnormalities in the caudal cervical spine. Vertebral malalignment and narrow intervertebral space correlated closely with myelographic cord compression. However, compressive lesions were not identified in 11 cases on plain films. Follow-up was available on 30 dogs of which 25 showed neurological improvement. This was temporary in 10 cases which were destroyed two weeks to three years following surgery.     

Incidence of motion loss of the stifle joint in dogs with naturally occurring cranial cruciate ligament rupture surgically treated with tibial plateau leveling osteotomy: longitudinal clinical study of 412 cases

OBJECTIVE: To report the incidence of loss of stifle extension or flexion and its relationship with clinical lameness after tibial plateau leveling osteotomy (TPLO) for treatment of cranial cruciate ligament (CCL) rupture. STUDY DESIGN: Longitudinal study. ANIMALS: Dogs (n=280) with CCL rupture (n=412). METHODS: TPLO was performed without meniscal release or arthrotomy. Angles of extension and flexion of the stifle were measured by goniometry to determine range of motion. Based upon motion loss, stifles were divided in 3 groups: no loss of extension or flexion (n=322), <10 degrees loss of extension or flexion (n=78), > or =10 degrees loss of extension or flexion (n=12). RESULTS: Loss of extension or flexion > or =10 degrees was associated with significantly (P=.001) higher clinical lameness scores in comparison with no loss, or loss of extension or flexion <10 degrees. Osteoarthrosis in the cranial femorotibial joint was significantly correlated (P<.005, r(2)=0.55) with loss of extension. Loss of extension > or =10 degrees was less tolerable and less amenable to physical rehabilitation than flexion loss. CONCLUSIONS: Loss of extension or flexion > or =10 degrees was responsible for higher clinical lameness scores. Osteoarthrosis in the cranial femorotibial joint led to extension loss. CLINICAL RELEVANCE: Loss of extension or flexion should be assessed in dogs with persistent clinical lameness after TPLO so that early intervention can occur. Our study provides guidelines to define clinically relevant loss of extension or flexion of stifle joint after TPLO.     

Dynamic Compression of the Cervical Spinal Cord: A Myelographic and Pathologic Investigation in Great Dane Dogs

The authors report the radiographic and pathologic findings in 10 Great Dane dogs with the wobbler syndrome. In all 10 dogs it was possible to demonstrate myelographically that there was cervical spinal cord compression at 1 or 2 sites. The spinal cord compression was mainly dynamic in nature, as degree of compression increased in extension and decreased in flexion of the neck in 8 dogs. In 1 dog with deformed vertebral bodies (G6 and C7), compression increased slightly in flexion of the neck. In another dog, compression was lateral and could only be seen in the ventrodorsal view.The macroscopic findings substantiated the radiologic findings. The cause of the spinal cord compression was in 8 dogs a decrease in the dorsoventral diameter of the orifice of the vertebral canal of 1 or 2 vertebrae in combination with deformation and elongation of 1 or several vertebral arches. In extension of the neck, the cervical spinal cord was squeezed between the anterior tip of the elongated vertebral arch and the caudodorsal rim of the body of the adjacent cranial vertebra.Histologic examination was made of the spinal cord in 5 dogs and the compressive lesions that were found could explain the neurologic signs.In the discussion, the question is raised as to why pain is not a prominent sign in dogs with the wobbler syndrome in contrast to in dogs with cervical disc protrusion. It is believed that the inflammatory foreign body reaction, triggered by the protruded calcified nucleus pulposus is the main cause of pain in the disc protrusion syndrome. In the wobbler syndrome there is no obvious inflammatory reaction in the epidural space.Finally, the possible etiologic factors oC importance for the deformation oC the cervical vertebrae in wobblers are discussed. There are indications that both overnutrition and a genetic trait for rapid growth are of importance.     

Spinal biomechanics and functional anatomy.

Knowledge of the normal functional behavior and mechanical properties of the vertebral column is important to understand the pathogenesis of back lesions, to identify the clinical manifestations of back pain, and to ensure a rational approach to physical therapy. The purpose of this article is to present a synthesis of in vivo and in vitro data obtained from different but complementary investigations. Presently, in vivo studies are limited; few gait-specific kinematic and electromyographic investigations are in process. Higher stresses to reach the maximal range of intervertebral motion can be applied on the spine on anatomical specimens than in living horses, and anatomical functional data can be obtained at the level of intervertebral structures. For each movement of flexion, extension, lateroflexion, and rotation, regional and intervertebral mobility is presented with an emphasis on craniocaudal variations and their anatomical causes. Because of the location of their ICR, the dorsoventral movements of a thoracolumbar intervertebral joint can be defined as a rotation around the center of the more caudal vertebral body. This information supports the new concept of intervertebral mobility in the horse and provides additional elements to facilitate understanding of the pathogenesis of back problems in the horse.     

MAGNETIC RESONANCE IMAGING FEATURES OF CERVICAL SPINAL CORD MENINGIOMAS

The records of four dogs with cervical spinal cord meningiomas were retrospectively reviewed. Signalment, history, laboratory findings, neurological examination, and histopathological findings were evaluated. Magnetic resonance imaging (MRI) was performed using a 1.0-T superconducting magnet and T2-weighted (W) and noncontrast and postcontrast T1-W spin echo pulse sequences. Meningiomas were located at the level of the second, third, and fifth cervical vertebrae and the C2-3 intervertebral space. All meningiomas appeared as focal masses that were hyperintense to the spinal cord on T2-W images and iso- to hypointense on the T1-W images. They could be identified as intradural and extramedullary in origin based on a broad-based dural margin seen on at least one of the imaging planes and a gradual expansion of the subarachnoid space cranial and caudal to the mass, best noted on the transverse and dorsal plane images. On dorsal plane T2-W images in three dogs, expansion of the subarachnoid space adjacent to the mass appeared similar to the myelographic "golf tee" sign. All meningiomas exhibited moderate, well-defined contrast enhancement with dural tails seen in three of the four dogs. One dog had extension into the intervertebral foramen along the nerve and ipsilateral atrophy of the muscles of the neck. By differentiating the meningiomas from intramedullary tumors and by clearly depicting the extent of the masses, MRI provided valuable information about treatment options and prognosis.     

Cervical spondylomyelopathy (wobbler syndrome) in the Boerboel

The Boerboel is a South African large-breed dog resembling a Bullmastiff. The records of Onderstepoort Veterinary Academic Hospital were searched for dogs that had presented, between 1998 and 2003, with symptoms indicative of wobbler syndrome and had undergone survey radiographic and myelographic studies. Ten cases fitted the inclusion criteria. Dogs presented within the first 2 years of life, often with acute onset of symptoms. All presented with pelvic limb and 6 with concomitant thoracic limb ataxia or paresis. Treatment varied and included none (4), prednisolone (2), and dorsal laminectomy (2). Two dogs were euthanased at the time of diagnosis. The breed appears to be affected with a form of spondylomyelopathy that comprises bony malformation of cervical and/or thoracic vertebrae. In 8 dogs, malformations were evident on survey radiographs and were characterised by enlarged, irregular articular facets and associated medial deviation of the pedicles. These changes resulted in axial compression of the spinal cord best seen on ventrodorsal or dorsoventral myelographic studies. Multiple vertebrae were affected in some dogs and lesions were not confined to the caudal area of the cervical spine. Three dogs were alive and without symptoms at follow-up. Four were euthanased as a result of the disease and 1 died as a result of post-operative complications. Two additional dogs presenting with wobbler clinical signs are also described. One had medial deviation of the T5 and T6 caudal pedicles and 1 dog suffered from multiple cervical articular facet synovial cysts.     

Development and Variation of the Lateral Vertebral Foramen of the Atlas in Dogs

Postnatal development and variation of the bony cranial border of the lateral vertebral foramen (LVF) of the atlas was studied in 96 dogs. Developmental ossification was investigated in 8 known-aged Miniature Schnauzer pups, after each atlas was prepared either as an alizarin-red stained clearing or as a dried cleaned bone. Variation was investigated in 63 atlases from mature dogs and by study of radiographs from 25 mature dogs of various breeds. The soft tissue structures passing through the LVF and attaching to its cranial border were dissected in an additional 2 embalmed and 2 fresh cadavers. In 2-week-old pups, the LVF was represented by a notch in the cranial margin of the bony arch of the atlas, with a cartilage bar completing the foramen cranially. Between 6 and 16 weeks the bar forming the cranial bony border of the LVF ossified in its preexisting cartilage anlage. In mature dogs, the LVF was present in the craniolateral aspect of the arch of the atlas and was recognized on lateral radiographs. The vertebral artery and vein, and first cervical nerve passed through the LVF and the atlantooccipital joint capsule and dorsal membrane attached to the cranial border of the LVF. In one dog the cranial border of the LVF of the atlas was incompletely ossified bilaterally. This developmental variant was compared with variations in man and other mammals, and with proatlas neural arch derivatives.     

Inclination of the patellar ligament in relation to flexion angle in stifle joints of dogs without degenerative joint disease

OBJECTIVE: To measure the angles between the patellar ligament and the tibial plateau and between the patellar ligament and the common tangent at the tibiofemoral contact point (TFCP) throughout the full range of motion of the stifle joint in dogs and determine the flexion angles at which the patellar ligament is perpendicular to the tibial plateau or to the common tangent. SAMPLE POPULATION: 16 hind limbs from cadavers of 9 adult dogs without radiographically detectable degenerative joint disease. PROCEDURES: Mediolateral radiographic views of the stifle joints from full extension through full flexion were obtained (10 degrees increments). Angles between the tibial and femoral long axes (beta), between the patellar ligament and the tibial plateau gamma), and between the patellar ligament and the common tangent at TFCP (alpha) were measured. Data were analyzed via simple linear regression. RESULTS: In canine stifle joints, angles gamma and alpha decreased linearly with increasing flexion (angle beta). The patellar ligament was perpendicular to the tibial plateau and perpendicular to the common tangent at the TFCP at 90 degrees and 110 degrees of flexion, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: By use of the conventionally defined tibial plateau, data suggest that at approximately 90 degrees of flexion in stifle joints of dogs, shear force in the sagittal plane exerted on the proximal portion of the tibia shifts the loading from the cranial to the caudal cruciate ligament. Analyses involving the common tangent at the TFCP (a more anatomically representative reference point) identified this crossover point at approximately 110 degrees of joint flexion.     

Cervical spinal kinematics: a comparison between foals and adult horses

A photographic method was used to measure axial rotation, dorsoventral flexion and extension and lateral bending at each intervertebral joint complex from the occiput to the first thoracic vertebra in spinal segments from 19 foals under 12 months of age and 14 horses over three years of age. Comparisons between the two groups showed that there was a general reduction in cervical spinal mobility with age. For the three types of movement at the eight joints tested, adults' mobility exceeded that of foals in only three cases (axial rotation and lateral bending at the A-O joint, and lateral bending at C7-T1). These differences were not significant (P greater than 0.05). In the remaining 21 cases the amplitude of movement was greater in the foals, the differences being significant (P less than 0.05) in 16 cases. With regard to overall mobility of the cervical spine the foals exceeded the adults by 17.3 per cent for axial rotation, 22.0 per cent for dorsoventral flexion and extension and 18.7 per cent for lateral bending.     

The Effect of Marker Location Variability on Noninvasive Canine Stifle Kinematics

Objective: Evaluate the effect of marker placement on kinematics of the canine stifle in 3 distinct hindlimb models. Study Design: In vivo biomechanical study. Animals: Normal adult mixed‐breed dogs (n=5). Methods: Ten retroreflective markers were affixed to the skin on the right rear leg of each dog to establish normal stifle kinematics. Four additional markers were placed around the greater trochanter (GT), 2 cm cranial, caudal, dorsal, and ventral to evaluate single marker placement variability on kinematic model data. Dogs were walked and trotted 5 times through the calibrated space. Sagittal flexion and extension angle waveforms were acquired during each trial with 3 models that were produced simultaneously during each gait. The GT marker was reassigned to 1 of the 4 additional locations (cranial, caudal, dorsal, and ventral) to alter the kinematic model. Comparison of sagittal flexion and extension angle waveforms was performed with Generalized Indicator Function Analysis. Results: Each model provided consistent equivalent sagittal flexion–extension data. Analysis revealed statistically significant differences between all GT locations. The differences were greatest in the cranial and caudal locations for all models. Conclusions: Deviation of the GT marker in the cranial/caudal direction from an anatomically normal position produces a greater degree of difference than deviation in a dorsal/ventral direction.