Estabilização cirúrgica da coluna vertebral cervical em ovino / Cervical spinal cord surgical stabilization in a sheep

Background: Trauma is the main cause of spinal fractures and dislocations in humans and large animals. Clinical signspresent with acute onset and vary according to the location and severity of the spinal cord injury. The treatment of fractures in large animals depends on economic value, cost of procedures, prognosis, location and type of fracture. However,although spinal fractures in large animals are not uncommon, the literature about their clinical aspects and treatment isscanty. Therefore, the purpose of this report is to describe a surgical stabilization of atlantoaxial subluxation, fracture ofthe third cervical vertebra and C2-C3 subluxation.Case: An approximately 2-year-old Île-de-France sheep, weighing 101 kg, with a history of cervical trauma and nonambulatory tetraparesis was treated at the Veterinary Hospital of the Institution (UNIPAMPA). During physical examination, the animal presented good general physical condition and heart rate, respiratory rate and temperature was accordingto physiological parameters for the species. The animal remained in lateral decubitus, with minimal head and limb movements, and exhibited deep pain sensitivity. Clinical treatment with dexamethasone, limb physiotherapy and change inlateral decubitus position were employed, but failed to improve the animal’s condition. After five days of unresponsive toclinical treatment, the patient was referred to the neurology department, where it underwent neurological examination andradiographic examination of the cervical region was performed under general anesthesia. The radiographic examinationrevealed atlantoaxial subluxation, by displacement of the odontoid process into the vertebral canal, fracture of the thirdcervical vertebra and C2-C3 vertebral subluxation. The surgical planning aimed cervical vertebral instability repair usingatlantoaxial arthrodesis associated the stabilization of C1-C2 and C2-C3 vertebrae with Schanz pins and bone cement...

Estabilização cirúrgica da coluna vertebral cervical em ovino / Cervical spinal cord surgical stabilization in a sheep

Background: Trauma is the main cause of spinal fractures and dislocations in humans and large animals. Clinical signspresent with acute onset and vary according to the location and severity of the spinal cord injury. The treatment of fractures in large animals depends on economic value, cost of procedures, prognosis, location and type of fracture. However,although spinal fractures in large animals are not uncommon, the literature about their clinical aspects and treatment isscanty. Therefore, the purpose of this report is to describe a surgical stabilization of atlantoaxial subluxation, fracture ofthe third cervical vertebra and C2-C3 subluxation.Case: An approximately 2-year-old Île-de-France sheep, weighing 101 kg, with a history of cervical trauma and nonambulatory tetraparesis was treated at the Veterinary Hospital of the Institution (UNIPAMPA). During physical examination, the animal presented good general physical condition and heart rate, respiratory rate and temperature was accordingto physiological parameters for the species. The animal remained in lateral decubitus, with minimal head and limb movements, and exhibited deep pain sensitivity. Clinical treatment with dexamethasone, limb physiotherapy and change inlateral decubitus position were employed, but failed to improve the animals condition. After five days of unresponsive toclinical treatment, the patient was referred to the neurology department, where it underwent neurological examination andradiographic examination of the cervical region was performed under general anesthesia. The radiographic examinationrevealed atlantoaxial subluxation, by displacement of the odontoid process into the vertebral canal, fracture of the thirdcervical vertebra and C2-C3 vertebral subluxation. The surgical planning aimed cervical vertebral instability repair usingatlantoaxial arthrodesis associated the stabilization of C1-C2 and C2-C3 vertebrae with Schanz pins and bone cement...(AU)

Long-term clinical complications associated with the use of polymethyl methacrylate in spinal stabilization of dogs and cats: case series / Complicações clínicas de longo prazo relacionadas ao uso de pino ou parafuso/polimetilmetacrilato na estabilização espinhal de cães e gatos: série de casos

Vertebral and spinal cord trauma are common conditions in small animal practice and often result in vertebral fractures/luxation (VFL) with concomitant spinal cord laceration, concussion, compression, or ischemia. These lesions have several clinical presentations that may vary from moderate to severe pain and partial to total loss of motor, sensory, and visceral functions, which may result in death or euthanasia. Our purpose is to describe five cases (four dogs and one cat) of complications secondary to the use of bone cement for vertebral stabilization. The patients, between five months and four years of age and weighing between 1.4 and 12.2 kg, were referred to the Small Animal Orthopedics and Traumatology Service of the Veterinary Hospital of the College of Veterinary Medicine and Animal Science of the University of São Paulo. They had a history of post-operatory polymethyl methacrylate (PMMA) reactions (such as drainage or cement exposure due to infection or implant failure) in periods from 9 to 18 months after undergoing spinal osteosynthesis. Surgical implant removal occurred in 80% of the patients (4/5). Complete remission was not observed in the patient with residual implants. The association of pins/screws and PMMA is a versatile osteosynthesis technique and is applicable in all spinal regions. However, delayed complications can occur, which could require additional surgical procedures. Despite the small number of cases included in this study, one can infer that complications related to the use of bone cement in spinal surgery can occur in the long term and should be highlighted during the implant choosing process for vertebral osteosynthesis in small animals.

O trauma vertebromedular é uma afecção comum na rotina clínica de pequenos animais e resulta, muitas vezes, em fraturas e luxações vertebrais (FLV) associadas à laceração, concussão, compressão ou isquemia da medula espinhal. Essas lesões apresentam sinais clínicos que variam de dor moderada a grave, acompanhada por perda parcial ou total das funções motoras, sensoriais e viscerais, podendo resultar no óbito ou na indicação de eutanásia. O objetivo deste trabalho é descrever cinco casos de complicações inerentes o uso de cimento ósseo para estabilização vertebral em quatro cães e um gato. Os pacientes possuíam idades variando entre cinco meses a quatro anos, peso entre 1,4 e 12,2kg e foram atendidos no Serviço de Ortopedia e Traumatologia do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, com histórico de reações cutâneas ao polimetilmetacrilato (PMMA), como tratos drenantes ou exposição do cimento decorrente de infecção ou soltura precoce do implante, em períodos que variaram de nove à 18 meses após serem submetidos a osteossíntese da coluna vertebral. Foi realizada a remoção cirúrgica desses implantes em quatro pacientes e mantida a estabilização prévia em um caso. Houve resolução total do quadro de infecção nos pacientes em que se removeu o PMMA associada ao tratamento clínico, e remissão parcial no paciente em que o implante não pode ser removido. A utilização do cimento ósseo associado a parafusos ou pinos é uma técnica versátil e aplicável em todas as regiões da coluna vertebral, no entanto complicações tardias são possíveis, sendo necessário muitas vezes procedimentos cirúrgicos adicionais para a resolução do problema. Apesar da pequena quantidade de casos relatados, foi possível observar que complicações relacionadas ao uso do cimento ósseo na coluna vertebral podem ocorrer no médio ao longo prazo [...].

Long-term clinical complications associated with the use of polymethyl methacrylate in spinal stabilization of dogs and cats: case series / Complicações clínicas de longo prazo relacionadas ao uso de pino ou parafuso/polimetilmetacrilato na estabilização espinhal de cães e gatos: série de casos

Vertebral and spinal cord trauma are common conditions in small animal practice and often result in vertebral fractures/luxation (VFL) with concomitant spinal cord laceration, concussion, compression, or ischemia. These lesions have several clinical presentations that may vary from moderate to severe pain and partial to total loss of motor, sensory, and visceral functions, which may result in death or euthanasia. Our purpose is to describe five cases (four dogs and one cat) of complications secondary to the use of bone cement for vertebral stabilization. The patients, between five months and four years of age and weighing between 1.4 and 12.2 kg, were referred to the Small Animal Orthopedics and Traumatology Service of the Veterinary Hospital of the College of Veterinary Medicine and Animal Science of the University of São Paulo. They had a history of post-operatory polymethyl methacrylate (PMMA) reactions (such as drainage or cement exposure due to infection or implant failure) in periods from 9 to 18 months after undergoing spinal osteosynthesis. Surgical implant removal occurred in 80% of the patients (4/5). Complete remission was not observed in the patient with residual implants. The association of pins/screws and PMMA is a versatile osteosynthesis technique and is applicable in all spinal regions. However, delayed complications can occur, which could require additional surgical procedures. Despite the small number of cases included in this study, one can infer that complications related to the use of bone cement in spinal surgery can occur in the long term and should be highlighted during the implant choosing process for vertebral osteosynthesis in small animals.(AU)

O trauma vertebromedular é uma afecção comum na rotina clínica de pequenos animais e resulta, muitas vezes, em fraturas e luxações vertebrais (FLV) associadas à laceração, concussão, compressão ou isquemia da medula espinhal. Essas lesões apresentam sinais clínicos que variam de dor moderada a grave, acompanhada por perda parcial ou total das funções motoras, sensoriais e viscerais, podendo resultar no óbito ou na indicação de eutanásia. O objetivo deste trabalho é descrever cinco casos de complicações inerentes o uso de cimento ósseo para estabilização vertebral em quatro cães e um gato. Os pacientes possuíam idades variando entre cinco meses a quatro anos, peso entre 1,4 e 12,2kg e foram atendidos no Serviço de Ortopedia e Traumatologia do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, com histórico de reações cutâneas ao polimetilmetacrilato (PMMA), como tratos drenantes ou exposição do cimento decorrente de infecção ou soltura precoce do implante, em períodos que variaram de nove à 18 meses após serem submetidos a osteossíntese da coluna vertebral. Foi realizada a remoção cirúrgica desses implantes em quatro pacientes e mantida a estabilização prévia em um caso. Houve resolução total do quadro de infecção nos pacientes em que se removeu o PMMA associada ao tratamento clínico, e remissão parcial no paciente em que o implante não pode ser removido. A utilização do cimento ósseo associado a parafusos ou pinos é uma técnica versátil e aplicável em todas as regiões da coluna vertebral, no entanto complicações tardias são possíveis, sendo necessário muitas vezes procedimentos cirúrgicos adicionais para a resolução do problema. Apesar da pequena quantidade de casos relatados, foi possível observar que complicações relacionadas ao uso do cimento ósseo na coluna vertebral podem ocorrer no médio ao longo prazo [...].(AU)