Surgical management and long‐term outcome of dogs with cervical spondylomyelopathy with an anchored intervertebral titanium device

Jc, King; Corfield, GS; Jg, Mouatt; Kan, CY; Pa, Moses

doi:10.1111/avj.12910

Cited by 4 publications

(20 citation statements)

References 40 publications

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“…The same is observed in human studies (57). A variety of surgical techniques have been proposed for the treatment of DA-CSM in dogs, with success rates between 70 and 90% (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). The purpose of surgical intervention should be to improve neurological deficits or, in more severe cases, to stop or slow down progression, by relieving the spinal cord compression and stabilizing the cervical vertebrae, anytime a dynamic component is suspected (1,10).…”

Section: Discussionmentioning

confidence: 99%

“…The use of intervertebral body cages with or without adjuvant locking plates to achieve interbody arthrodesis rapidly gained acceptance in humans. More recently, the technique became popular for dogs (32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(57)(58)(59)(60)(61)(62). Based on our previous experience of more than 30 cases, the use of the intervertebral cage alone or in combination with ventral plating was often insufficient to maintain the required intervertebral body distraction with a high incidence of subsidence, despite relatively good clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…We hypothesized that the discs extruded due to the collapse of the intervertebral disc space with residual disc material entering the vertebral canal. When selecting a surgical technique for the management of patients with DA-CSM, the success rate and the potential risks of complications such as implant failure and subsidence should be considered (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)49). Subsidence is commonly associated with many surgical techniques used to treat DA-CSM.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment offers more benefits than medical treatment (1,11,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). A variety of surgical techniques have been proposed for DA-CSM, with many of the authors claiming success rates between 70 and 90% (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44). Surgical options include the distraction-stabilization of the affected vertebral segments and more recently, the implantation of a prosthetic disc (PD) (11,(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)…”

Section: Introductionmentioning

confidence: 99%

“…The goal of both surgeries is to relieve spinal cord compression. However, the prosthetic disc aims to achieve relatively normal vertebral motion, whereas distraction-stabilization aims for vertebral fusion (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(47)(48)(49). In this study, we retrospectively analyzed the records of dogs with DA-CSM treated via prosthetic disc implantation or vertebral distraction-fixation and evaluated the clinical outcomes and the imaging findings.…”

Section: Introductionmentioning

confidence: 99%

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

Falzone¹,

Tranquillo

Gasparinetti³

2022

Front. Vet. Sci.

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Falzone¹,

Tranquillo

Gasparinetti³

2022

Front. Vet. Sci.

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Instrumented cervical fusion using patient specific end-plate conforming interbody devices with a micro-porous structure in nine dogs with disk-associated cervical spondylomyelopathy

Driver

López

Walton³

et al. 2023

Front. Vet. Sci.

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ObjectiveTo report the medium and long-term outcome of nine dogs with disk-associated cervical spondylomyelopathy (DA-CSM), treated by instrumented interbody fusion using patient specific end-plate conforming device that features a micro-porous structure to facilitate bone in-growth.Study designA retrospective clinical study.AnimalsNine medium and large breed dogs.MethodsMedical records at two institutions were reviewed between January 2020 and 2023. Following magnetic resonance imaging (MRI) diagnosis of DA-CSM, pre-operative computed tomography (CT) scans were exported to computer software for in-silico surgical planning. Interbody devices were 3D-manufactured by selecting laser melting in titanium alloy. These were surgically implanted at 13 segments alongside mono-or bi-cortical vertebral stabilization systems. Follow-up included neurologic scoring and CT scans post-operative, at medium-term follow up and at long-term follow-up where possible. Interbody fusion and implant subsidence were evaluated from follow-up CT scans.ResultsNine dogs were diagnosed with DA-CSM between C5-C7 at a total of 13 operated segments. Medium-term follow up was obtained between 2 and 8 months post-operative (3.00 ± 1.82 months). Neurologic scoring improved (p = 0.009) in eight of nine dogs. Distraction was significant (p < 0.001) at all segments. Fusion was evident at 12/13 segments. Subsidence was evident at 3/13 operated segments but was only considered clinically relevant in one dog that did not improve; as clinical signs were mild, revision surgery was not recommended. Long-term follow up was obtained between 9 and 33 months (14.23 ± 8.24 months); improvement was sustained in 8 dogs. The dog that suffered worsened thoracic limb paresis at medium-term follow up was also diagnosed with immune-mediated polyarthropathy (IMPA) and was euthanased 9 months post-operative due to unacceptable side-effects of corticosteroid therapy.ConclusionEnd-plate conforming interbody devices with a micro-porous structure were designed, manufactured, and successfully implanted in dog with DA-CSM. This resulted in CT-determined fusion with minimal subsidence in the majority of operated segments.Clinical significanceThe technique described can be used to distract and fuse cervical vertebrae in dogs with DA-CSM, with favorable medium-and long-term outcomes.

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

Tabbì

Barillaro²,

Interlandi

et al. 2023

Animals

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Canine disc-associated cervical spondylomyelopathy (DA-CSM) is a form of caudal CSM, characterized by the compression of the spinal cord and nerve roots due to an intervertebral disc protrusion. It is more frequent in large canine breeds. A variety of surgical techniques has been proposed for DA-CSM. The aim of the study was to evaluate the outcomes of a cervical distraction–stabilization technique using an intervertebral anchored fusion device (C-LOX) combined with a locking compression plate (LCP plate) for the treatment of DA-CSM in dogs, based on clinical and radiographical follow-up data. Thirteen dogs affected by DA-CSM were included in the study. After the surgical procedure, an improvement in neurological status was documented in 9/13 cases. This cervical distraction–stabilization technique seems to be a valuable surgical alternative to treat this canine pathology.

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Surgical management and long‐term outcome of dogs with cervical spondylomyelopathy with an anchored intervertebral titanium device

Cited by 4 publications

References 40 publications

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

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

Instrumented cervical fusion using patient specific end-plate conforming interbody devices with a micro-porous structure in nine dogs with disk-associated cervical spondylomyelopathy

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

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