Cervical stabilization with polyaxial pedicle screw and rod construct in horses: A proof of concept study

Aldrich, Ellison; Nout‐Lomas, Yvette S.; Seim, Howard B.; Easley, Jeremiah T.

doi:10.1111/vsu.12938

Cited by 8 publications

(12 citation statements)

References 27 publications

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“…The 30‐mm‐length PPS used limited bone purchase—rostral screws engaged two cortices, while some caudal PPS engaged one cortex. However, unicortical engagement provided rigid stability in other ESF 15 and LCP constructs 10,21,22 . Longer screws were available but not readily accessible for these cases.…”

Section: Discussionmentioning

confidence: 99%

“…However, unicortical engagement provided rigid stability in other ESF 15 and LCP constructs. 10,21,22 Longer screws were available but not readily accessible for these cases.…”

Section: Discussionmentioning

confidence: 99%

“…4 Polyaxial pedicle screws (PPS) are frequently used in dogs and in man for spinal fusion and fixation, [7][8][9] and have recently been used in horses to achieve cervical vertebral stabilization. 10 The PPS are inserted by using standard screw insertion techniques and provide rigid stability similar to locking plate technology. These implants function similarly to ESF and have been investigated in vitro to stabilize equine mandibular osteotomies.…”

Section: Introductionmentioning

confidence: 99%

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Polyaxial pedicle screw external fixation to stabilize oblique mandibular fractures in three standing, sedated horses

et al. 2021

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Objective: To report the radiographic, surgical and postoperative features in horses with unstable oblique mandibular fractures secured with polyaxial pedicle screws (PPS) external fixation construct and intraoral wiring. Animals: Three client-owned horses. Study design: Short case series. Methods: Two horses each had a unilateral fracture, which did not improve after conservative management, and one horse had bilateral fractures. Clinical and radiographic features were documented. Polyaxial pedicle screw external fixators and intraoral tension band wiring were applied in standing horses after combining sedation and regional nerve anesthesia. Intraoral wires were implanted through a lateral buccotomy between teeth (two horses) or burred through exposed crown (one horse) and then secured around the incisors. The PPS were inserted under radiographic guidance to avoid tooth roots. Healing was assessed with radiographic examination. The PPS external fixator rod and intraoral wires were removed first. The mandible was manipulated, and, if it was stable, the PPS were removed. Results: Implants were removed at 6, 8, or 10 weeks after the mandibles were palpably stable. Complications included broken wires in one horse, bone sequestration in one horse, and infection in one horse. Follow-up communication with the owners 12 to 18 months later confirmed complete healing without further complications of the fractured mandibles or teeth. Conclusion: Polyaxial pedicle screw external fixation led to fracture healing and a return to function in all three horses. The complications encountered did not preclude a successful outcome. Clinical significance: Polyaxial pedicle screw external fixation coupled with intraoral wiring provides an alternative to treat unstable equine mandibular fractures without general anesthesia.

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Section: Discussionmentioning

confidence: 99%

“…However, unicortical engagement provided rigid stability in other ESF 15 and LCP constructs. 10,21,22 Longer screws were available but not readily accessible for these cases.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Polyaxial pedicle screw external fixation to stabilize oblique mandibular fractures in three standing, sedated horses

et al. 2021

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“…Two common surgical procedures for cervical stabilization are the use of a Bagby basket [146,147] or a kerf-cut cylinder [148]. A more recent method being applied is with a polyaxial pedicle screw and rod construct [149]. All of these procedures are technically demanding and should be performed only by those with a solid understanding of the cervical anatomy and a high level of surgical training.…”

Section: Cervical Vertebral Stabilizationmentioning

confidence: 99%

Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment

Story

Haussler

Nout‐Lomas

et al. 2021

Animals

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Interest in the cervical spine as a cause of pain or dysfunction is increasingly becoming the focus of many equine practitioners. Many affected horses are presented for poor performance, while others will present with dramatic, sometimes dangerous behavior. Understanding and distinguishing the different types of neck pain is a starting point to comprehending how the clinical presentations can vary so greatly. There are many steps needed to systematically evaluate the various tissues of the cervical spine to determine which components are contributing to cervical pain and dysfunction. Osseous structures, soft tissues and the central and the peripheral nervous system may all play a role in these various clinical presentations. After completing the clinical evaluation, several imaging modalities may be implemented to help determine the underlying pathologic processes. There are multiple treatment options available and each must be carefully chosen for an individual horse. Provided is a synopsis of the current knowledge as to different disease processes that can result in cervical pain and dysfunction, diagnostic approaches and treatment strategies. Improving the knowledge in these areas will ideally help to return horses to a state of well-being that can be maintained over time and through the rigors of their job or athletic endeavors.

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“…The cervical spine is currently receiving increased attention as a source of dysfunction in the equine patient. 1,2 The range of motion of the seven cervical vertebrae (C 1-7 ) has major implications for equine locomotor function as the neck acts as a lever and aids the horses balance. 3,4 The three main types of movement occurring in the motion segments of the equine spine include flexion and extension, lateral bending and axial rotation.…”

Section: Introductionmentioning

confidence: 99%

Computed Tomographic Evaluation of Adjacent Segment Motion after Ex Vivo Fusion of Equine Third and Fourth Cervical Vertebrae

Schulze

Ehrle

Weller

et al. 2019

Vet Comp Orthop Traumatol

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Objective Surgical fusion of vertebral segments is a treatment option for horses with cervical stenotic myelopathy or cervical fracture.Degenerative disease affecting adjacent vertebral segments is a reported complication following surgical vertebral fusion in other species, termed adjacent segment disease. The aim of this study was to evaluate the impact of cervical vertebral fusion on the biomechanics of adjacent vertebral segments in the horse. Study Design Neck specimens of 12 horses were assessed using computed tomographic imaging. Range of motion (ROM) was determined by measuring the maximum sagittal flexion, extension and lateral bending between C2 and C5. C3/4 was subsequently fused using a standard locking compression plate and locking head screws and computed tomographic scans and ROM measurements were repeated. Results Prior to intervertebral fusion, a significant increase in ROM along the vertebral segments from cranial to caudal was observed. Range of motion measurements of C3/4 decreased significantly after fusion (p = 0.01).Range of motion of the adjacent segments (C2/3 and C4/5) did not change significantly after fusion. Conclusion Fusion of one cervical intervertebral joint did not affect the ROM of the adjacent vertebral segments. Further research investigating the implications of vertebral fusion on the intervertebral pressure in the equine patient is indicated.

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Cervical stabilization with polyaxial pedicle screw and rod construct in horses: A proof of concept study

Abstract: The results of this study justify evaluation of this technique in horses with a diagnosis of cervical vertebral compressive myelopathy.

Cited by 8 publications

References 27 publications

Polyaxial pedicle screw external fixation to stabilize oblique mandibular fractures in three standing, sedated horses

Polyaxial pedicle screw external fixation to stabilize oblique mandibular fractures in three standing, sedated horses

Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment

Computed Tomographic Evaluation of Adjacent Segment Motion after Ex Vivo Fusion of Equine Third and Fourth Cervical Vertebrae

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