Will There be a Role for Disc Prostheses in Small Animals?

Adamo, Filippo; Forterre, Franck

doi:10.1002/9781118940372.ch40

Cited by 3 publications

(6 citation statements)

References 61 publications

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“…Total disc replacement (disc arthroplasty) is used to maintain the functional vertebral motion unit. It has been investigated extensively in man, but veterinary application in dogs is rare, and long‐term follow‐up studies are lacking …”

Section: Introductionmentioning

confidence: 99%

“…It has been investigated extensively in man, but veterinary application in dogs is rare, and long-term follow-up studies are lacking. [10][11][12][13] Spinal fusion is currently considered the gold standard in surgical treatment of cervical myelopathy, the human analog disease for CCSM in dogs. 10,14 Bone bridging between the vertebral endplates is the objective of surgery because implants alone may not provide lifelong stability.…”

Section: Introductionmentioning

confidence: 99%

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Instrumented cervical fusion in nine dogs with caudal cervical spondylomyelopathy

et al. 2019

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Objective To report the long‐term outcome of nine dogs treated for caudal cervical spondylomyelopathy (CCSM) with surgical spinal fusion. Study design Short case series. Animals Nine large‐breed dogs. Methods Medical records of dogs treated for disc‐associated CCSM (2013‐2016) were reviewed. The surgery objective was spinal distraction by implantation of a SynCage and fixation with two Unilock plates. Follow‐up included the Helsinki pain score questionnaire, neurological grading, radiography, computed tomography (CT), and micro‐CT (μCT) with subsequent histopathology (two dogs). Results Clinical follow‐up was obtained between 9 and 51 months (27.4 ± 13.4 months). The Helsinki pain score and neurological Griffith score improved (P < .01) in all dogs and in eight of nine dogs, respectively. According to CT, the volume of bone (mean ± SD) through the cage was 79.5% ± 14.3%, including compact bone (53.0% ± 23.4%). Subsidence was seen in one of nine dogs. Implant failure was evident in four dogs, and plates were removed in two dogs. In seven of nine dogs, infraclinical pathology was observed in adjacent segment, associated with implants engaging adjacent intervertebral discs. Radiographic evidence of bony fusion between vertebral bodies was noted in all dogs. Spinal fusion was confirmed by μCT and histopathology in two cervical spine segments that became available at 22 and 40 months postoperatively. Conclusion Instrumented spinal fusion in dogs with disc‐associated CCSM resulted in owner satisfaction and radiographic evidence of interbody spinal fusion in all dogs. Clinical significance The fusion distraction technique reported here can be used to achieve spinal fusion with a good long‐term outcome.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Instrumented cervical fusion in nine dogs with caudal cervical spondylomyelopathy

et al. 2019

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“…Some authors have reported good to excellent outcomes in most dogs that underwent cervical arthroplasty surgery. The procedure has shown effectiveness in providing vertebral distraction and preserving segmental motion; although, complications such as subsidence with loss of vertebral distraction and vertebral instability have occurred over time (ADAMO et al, 2014a(ADAMO et al, , 2014bADAMO & FORTERRE, 2015). Subsidence of the prosthesis into the vertebral bodies is also one of the most commonly reported complications of intervertebral disc arthroplasty in humans ( VAN LOON & GOFFIN, 2012;PARISH et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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Cervical arthroplasty with disc prosthesis has been proposed as a treatment option for dogs with Cervical Spondylomyelopathy. The present study developed a novel vertebral disc prosthesis for dogs. Sixteen Functional Spinal Units (C5-C6) were collected from dog cadavers with body weights ranging between 25 and 35 kg, and their vertebral measurements were used to design a prosthetic disc. The sizing of the prosthesis was performed based on the averages of the measurements of width, height, and length of the vertebral bodies from C5-C6 of all specimens. The prosthesis was developed using the Rhinoceros 3D® and SolidWorks® programs, and 3D prototyping was carried out to define the best design. The developed prosthesis consisted of two independent parts that are fixed to the cranial and caudal vertebral bodies, in the intervertebral space, and fitted together by metal-to-metal surfaces capable of moving in the lateral, ventral, and dorsal directions. Each part of the prosthesis is angled in two portions: vertically, in the intervertebral space, and horizontally, in contact with the ventral surface of the vertebral bodies, both of which are fixed by means of monocortical locking screws. The design of the developed prototype allowed a good fit in the intervertebral space between C4-C5, C5-C6, and C6-C7.

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“…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)(49). The goal of both surgeries is to relieve spinal cord compression.…”

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%

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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Will There be a Role for Disc Prostheses in Small Animals?

Cited by 3 publications

References 61 publications

Instrumented cervical fusion in nine dogs with caudal cervical spondylomyelopathy

Instrumented cervical fusion in nine dogs with caudal cervical spondylomyelopathy

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

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

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