Comparison of Two Surgical Techniques for the Treatment of Canine Disc Associated-Cervical Spondylomyelopathy

Abstract

ObjectiveTo compare prosthetic disc and vertebral distraction stabilization in dogs with disc-associated cervical spondylomyelopathy (DA-CSM).Study DesignA retrospective clinical study.Animals25 dogs.MethodsDogs presenting with clinical signs and MRI findings compatible with DA-CSM underwent surgery. Implantation of the Adamo's prosthetic disc (PD) or vertebral distraction-stabilization (DS) with intervertebral cage, ventral locking plates, and dorsal transarticular screws was performed. All dogs were followed-up and evaluated clinically for a minimum of 1 year and radiographically for at least 3 months. In particular, we focused on the evaluation of subsidence (the degree of vertebral collapse).ResultsTwenty-five dogs were enrolled: 12 with PD implantation and 13 with DS implantation. Of these, 24 dogs were followed-up at 1 year. Overall, 12 dogs improved (4 PD and 8 DS), eight were stable (4 PD and 4 DS), and four deteriorated (3 PD and 1 DS). Deterioration was more common in PD cases, especially soon after surgery. In a few PD cases, a second surgery was necessary. The most common complication in dogs with DS was discospondylitis. Subsidence was detected in 11 PD and 7 DS dogs. Subsidence was more severe and occurred sooner after surgery in PD cases compared to DS cases. DS cases were more prone to clinical improvement and less prone to subsidence than PD cases in this study. However, the statistical evidence was weak owing to the small sample size.ConclusionThe preliminary results suggest that prosthetic disc implantation is more prone to clinical and radiographic failures than distraction stabilization.Clinical RelevanceThe DS technique is a valuable surgical option for treating dogs with DA-CSM, with favorable short- and long-term clinical and radiographic outcomes.

Development of an intervertebral disc prosthesis prototype for the canine cervical spine

“…Interbody subsidence is defined as the settling of an interbody into the adjacent vertebral bodies and is a known complication of their utilization throughout the spine (PINTER et al, 2021;XU et al, 2020). The complication rate represented especially by late prosthesis subsidence into the vertebral body, which varies from 14% (ADAMO et al, 2014b) to 92% (FALZONE et al, 2022), of the currently commercially available canine cervical prostheses stimulated the authors of the present study to develop a modified cervical disk prosthesis. This novel implant proposes improvements in the prosthesisvertebra interface considering the vertebral endplates' morphometric-based geometry with additional screw fixation, aiming to implant stability and; consequently, reducing the post-surgical morbidity rates described in the literature.…”

“…The disease is characterized by static and/ or dynamic lesions that mainly involve the caudal cervical region (C5-C6 and C6-C7) (BONELLI et al, 2021;FALZONE et al, 2022). This condition may be present in two forms: bone-associated compression, characterized especially by vertebral canal stenosis secondary to bone malformation and/or osteoarthritic alterations, and disc-associated, characterized by spinal cord compression caused by the protrusion of one or more intervertebral discs in combination or not with vertebral abnormalities (congenital vertebral canal stenosis), ligamentum flavum hypertrophy, and intervertebral foraminal stenosis (DA COSTA, 2010;DE DECKER et al, 2012;BONELLI et al, 2021).…”

Treatment of Canine Disc-Associated Cervical Spondylomyelopathy with a Cervical Distraction–Stabilization Technique (C-LOX Combined with LCP Plate) and Clinical Outcomes

“…DA-CSM, frequently identified in large-breed dogs [ 1 ], can cause non-traction-responsive (static lesions) and traction-responsive (dynamic lesions) cord compressions [ 41 ]. The ideal management for traction-responsive DA-CSM is still controversial.…”

“…The ideal management for traction-responsive DA-CSM is still controversial. Conservative treatment, despite initial improvement, may lead to further progression of the clinical signs [ 6 , 14 , 41 ].…”

Finite element analysis of a new intervertebral disc prosthesis developed for the canine cervical spine

“…The 14% (ADAMO et al, 2014b) to 92% (FALZONE et al, 2022) complication rate of late prosthesis subsidence the currently commercially available canine cervical prostheses led the authors to assess a new cervical disc prosthesis. This novel implant allows for adequate fixation onto the vertebral body with additional screw fixation to hold the device in position and homogeneous distribution of Von-Mises stresses and MiPS along the vertebral body, and does not overload the endplates.…”