Iatrogenic Sciatic Nerve Injury in Eighteen Dogs and Nine Cats (1997–2006)

Forterre, Franck; Tomek, Aleš; Rytz, Ulrich; Brunnberg, Leo; Jaggy, A.; Spreng, David

doi:10.1111/j.1532-950x.2007.00293.x

Cited by 65 publications

(100 citation statements)

References 6 publications

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“…Specifically, they showed no signs of pain, weakness, or lameness or changes in behaviors. From the period several hours after surgery and during the entire period while the cats were implanted, there were no signs of any ill effects from the C-FINE shells in terms of any difficulty trotting or gait abnormalities as described elsewhere [73], any other signs of weakness or decreased toe movement, or any decrease in sensation in the relevant dermatomes.…”

Section: Resultsmentioning

confidence: 58%

The design of and chronic tissue response to a composite nerve electrode with patterned stiffness

et al. 2017

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Objective As neural interfaces demonstrate success in chronic applications, a novel class of reshaping electrodes with patterned regions of stiffness will enable application to a widening range of anatomical locations. Patterning stiff regions and flexible regions of the electrode enables nerve reshaping while accommodating anatomical constraints of various implant locations ranging from peripheral nerves to spinal and autonomic plexi. Approach Introduced is a new composite electrode enabling patterning of regions of various electrode mechanical properties. The initial demonstration of the composite’s capability is the composite flat interface nerve electrode (C-FINE). The C-FINE is constructed from a sandwich of patterned PEEK within layers of pliable silicone. The shape of the PEEK provides a desired pattern of stiffness: stiff across the width of the nerve to reshape the nerve, but flexible along its length to allow for bending with the nerve. This is particularly important in anatomical locations near joints or organs, and in constrained compartments. We tested pressure and volume design constraints in vitro to verify that the C-FINE can attain a safe cuff-to-nerve ratio (CNR) without impeding intraneural blood flow. We measured nerve function as well as nerve and axonal morphology following 3 month implantation of the C-FINE without wires on feline peripheral nerves in anatomically constrained areas near mobile joints and major blood vessels in both the hind and fore limbs. Main Results In vitro inflation tests showed effective CNRs (1.93 ± 0.06) that exceeded the industry safety standard of 1.5 at an internal pressure of 20 mmHg. This is less than the 30 mmHg shown to induce loss of conduction or compromise blood flow. Implanted cats showed no changes in physiology or electrophysiology. Behavioral signs were normal suggesting healthy nerves. Motor nerve conduction velocity and compound motor action potential did not change significantly between implant and explant (p > 0.15 for all measures). Axonal density and myelin sheath thickness was not significantly different within the electrode compared to sections greater than 2 cm proximal to implanted cuffs (p > 0.14 for all measures). Significance We present the design and verification of a novel nerve cuff electrode, the C-FINE. Laminar manufacturing processes allow C-FINE stiffness to be configured for specific applications. Here, the central region in the configuration tested is stiff to reshape or conform to the target nerve, while edges are highly flexible to bend along its length. The C-FINE occupies less volume than other NCEs, making it suitable for implantation in highly mobile locations near joints. Design constraints during simulated transient swelling were verified in vitro. Maintenance of nerve health in various challenging anatomical locations (sciatic and median/ulnar nerves) was verified in a chronic feline model in vivo.

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Section: Resultsmentioning

confidence: 58%

The design of and chronic tissue response to a composite nerve electrode with patterned stiffness

et al. 2017

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“…14,15 Clinical signs with sciatic nerve injury include knuckling of the digits, sensory analgesia of the lower pelvic limb and decreased or absent gastrocnemius and cranial tibial tendon reflexes. 15 In the current case, there was no evidence that the surgical procedure itself had any direct effect on the injury.…”

Section: Discussionmentioning

confidence: 99%

Use of Physical Therapy in a Dog with Bilateral Severe Plantigrade Stance

Ree

Hayashi

Woelz

et al. 2015

Journal of the American Animal Hospital Association

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A 3.5 yr old spayed female Staffordshire terrier weighing 25.5 kg was presented with a 7 wk history of bilateral plantigrade stance in the pelvic limbs directly following an ovariohysterectomy procedure. Upon presentation, the dog had bilateral atrophy of the distal pelvic limb muscles, enlarged popliteal lymph nodes, and ulcerative wounds on the dorsa of her rear paws. Orthopedic examination revealed intact calcaneal tendons bilaterally and neurologic examination localized the lesion to the distal sciatic nerve. A diagnosis of compressive and stretch neuropathy was made affecting the distal sciatic nerve branches. Physical therapy modalities included neuromuscular electrical stimulation, ultrasound, and low-level laser therapy. Other therapeutic modalities included the use of orthotics and progressive wound care. The dog had increased muscle mass, return of segmental reflexes, return of nociception, and the ability to walk on pelvic limbs with higher carriage of the hock 15 mo following presentation. The use of custom orthotics greatly increased the quality of life and other physical therapy modalities may have improved the prognosis in this dog with severe bilateral plantigrade stance due to neuropathy.

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“…Iatrogenic sciatic nerve damage may occur following intramedullary pin application in femoral fractures (24). This may be particularly because during the bending of the intramedullary pins, the bent tips can also cause damage to the nerve.…”

Section: Discussionmentioning

confidence: 99%

The treatment of supracondylar and diaphyseal femoral fractures incats using intramedullary two-way stacked Kirschner wire application

Altunatmaz¹,

Karabağlı²,

Kaya³

et al. 2017

Turk J Vet Anim Sci

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Femoral fractures in cats are treated using pin and wires, lag screws, Rush pins, intramedullary threaded pins, interlocking pins, clamp rod internal fixators, and plates or plate-rods. In this study, 14 cats brought to the surgery clinic between the years 2010 and 2015 for fracture, due to either a road traffic accident or falling from a height, were evaluated. Following clinical and radiological examination of the cases, the type and location of the fracture, details of the applied fixation method, and postoperative clinical and radiological results were assessed. Localization of the fractures was as follows: 4 comminuted diaphyseal (1 segmental), 6 comminuted distal, and 4 uncomplicated distal transversal fractures. All fractures were closed. Following intramedullary positioning of the pins, rigid stabilization was observed in the fracture line. In the case of the segmental fracture, better stabilization was achieved when the medullary canal was completely filled. The patients were able to use their extremities 3-5 days after surgery and started walking normally from postoperative day 10. Functional healing was seen to improve gradually. Radiographic examination revealed sufficient calli to have formed between days 32 and 44. Complete healing and return to function with no complications was recorded in all the cases.

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Iatrogenic Sciatic Nerve Injury in Eighteen Dogs and Nine Cats (1997–2006)

Abstract: Iatrogenic sciatic nerve injury leads to severely debilitating locomotor dysfunction with an uncertain prognosis for full-functional recovery.

Cited by 65 publications

References 6 publications

The design of and chronic tissue response to a composite nerve electrode with patterned stiffness

The design of and chronic tissue response to a composite nerve electrode with patterned stiffness

Use of Physical Therapy in a Dog with Bilateral Severe Plantigrade Stance

The treatment of supracondylar and diaphyseal femoral fractures incats using intramedullary two-way stacked Kirschner wire application

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