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This paper describes, within the framework of a retrospective study, the epidemiological and clinicopathological findings in goats and sheep with compressive lesions of the central nervous system (CNS) in Pará. This study included eight sheep and three goats from 2005 to 2022 by reviewing the clinical files of animals with CNS compressive lesions managed by the team of the Carlos Tokarnia Veterinary Hospital of the Institute of Veterinary Medicine of the Federal University of Pará. The animals with clinical signs were subjected to a general and specific clinical examination of the nervous system. All animals included in the study were necropsied, and the clinical signs were found to vary according to the location of the lesion. At necropsy, changes such as an abscess with osteomyelitis of the vertebral body with pathologic fracture and spinal cord compression, submeningeal abscess in the skull floor, subarachnoid hematoma, and congenital bone changes causing spinal cord compression and ankylosing spondylitis were noted. These findings indicate that a comprehensive clinical examination of the CNS in conjunction with necropsy findings is essential to characterize the clinical picture, localize the lesion, and determine the cause of the disease. The most affected medullary segment was between T3 and L3. Therefore, these diseases should be included in the list of differential diagnoses in farm animals with nervous system symptoms.

O presente trabalho descreve, através de estudo retrospectivo, os achados epidemiológicos e clínico-patológicos em caprinos e ovinos com lesões compressivas no sistema nervoso central (SNC) no estado do Pará. O estudo retrospectivo compreendeu as observações realizadas em oito ovinos e três caprinos no período de 2005 a 2022, por meio da revisão dos arquivos de fichas clínicas de animais com lesões compressivas no SNC, atendidos pelo Hospital Veterinário Carlos Tokarnia do Instituto de Medicina Veterinária da Universidade Federal do Pará. Os animais atendidos com sintomatologia clínica foram submetidos a exames clínicos geral e específico do sistema nervoso. Todos os animais incluídos no estudo foram necropsiados. Os sinais clínicos variaram de acordo com a localização da lesão. Os achados de necropsia revelaram alterações como abscesso com osteomielite do corpo da vértebra com fratura patológica e compressão da medula espinhal; abscesso sub-meningeano no assoalho do crânio; hematoma subaracnoideo e alteração óssea congênita causando compressão medular e espondilite anquilosante. A realização de um minucioso exame clínico do SNC, associado aos achados de necropsia foi importante para caracterizar o quadro clínico, localizar a lesão e determinar a causa da enfermidade. O segmento medular mais acometido foi entre T3-L3. Torna-se importante incluir estas enfermidades na lista de diagnósticos diferenciais em animais de produção que apresentem sintomatologia nervosa.

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Lafora's disease is a genetic disease associated to mutations in genes that encodes laforin and malin, which results in intracellular polyglucan storage. The present report describes a case of Lafora's disease in a toco toucan with episodes of incoordination and myoclonus that resulted in traumatic lesions and fracture of the left hindlimb. The bird was euthanized and submitted to necropsy. Microscopically there were abundant PAS-positive and diastasis-resistant Lafora's inclusion bodies in neurons in the cerebellum, supporting the diagnosis of Lafora's disease.(AU)

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This retrospective study described the therapeutic modalities used for the rehabilitation of cats with neurological and orthopedic diseases and provided data regarding the number of sessions, frequency, and treatment duration; the study also evaluated the modality acceptance by this species. Twenty cats were selected, 11 with neurological diseases and nine with orthopedic conditions. Acute spinal cord trauma and femoral fracture were the most frequently observed neurological (72.7%) and orthopedic (44.4%) conditions, respectively. Manual therapies comprised of passive stretching (PS), passive range of motion (PROM), and bicycle movement (BM) exercises were included in all the protocols.Therapeutic modality acceptance was positive for physical agents, thermotherapy, and hydrotherapy (100%);in manual therapies, it was positive in 40% and partially positive in 60% of cats; in kinesiotherapy, it was positive for all the assisted active exercises and negative for the active exercises. The number of physical therapy sessions significantly influenced the positive acceptance of PS (P < 0.05). The PS, PROM, and BM exercises were the most commonly used modalities; the number of physiotherapy sessions and duration of treatment were higher in cats with neurological diseases, and acceptance was positive in most therapeutic modalities.

RESUMO: O objetivo deste estudo retrospectivo foi descrever as modalidades terapêuticas utilizadas na reabilitação de gatos com doenças neurológicas e ortopédicas em um centro de reabilitação, fornecer dados referentes ao número de sessões, a frequência, a duração do tratamento e avaliar a aceitação das modalidades pela espécie. Foram selecionados 20 gatos, sendo, 11 com doenças neurológicas e nove com afecções ortopédicas. O trauma agudo de medula espinhal e a fratura de fêmur foram as doenças neurológicas (72,7%) e ortopédicas (44,4%) mais observadas, respectivamente. As terapias manuais compostas pelos exercícios de alongamento passivo (AP), movimentação passiva articular (MPA) e movimento em bicicleta (MB) foram incluídas em 100% dos protocolos. A aceitação das modalidades terapêuticas foi positiva para os agentes físicos, termoterapia e hidroterapia (100%); nas terapias manuais, foi positiva em 40% e parcialmente positiva em 60% dos gatos e, na cinesioterapia, foi positiva para os exercícios ativos assistidos em 100% e negativa para os exercícios ativos. O número de sessões de fisioterapia influenciou significativamente na aceitação positiva do alongamento passivo (P < 0,05). O AP, a MPA, o MB foram as modalidades mais utilizadas; o número de sessões de fisioterapia e a duração do tratamento foram maiores nos gatos com doenças neurológicas e a aceitação foi positiva na maioria das modalidades terapêuticas.

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Background: Spinal epidural empyema (SEE) is a rare disease in cats that has been described as a cause of severe compressive myelopathy. It is characterized by accumulation of purulent exudate in the form of an abscess in the epidural space. Neurological signs range from spinal hyperesthesia to rapidly progressive paraplegia and may be associated with systemic signs. Spinal lymphoma is the most common neoplasm affecting the central nervous system of cats and can mimic different neoplasms and non-neoplastic diseases, such as SEE. The aim of this study is to report a case of SEE in a cat and highlight the similarities in neurological, laboratory, and imaging findings between this disease and spinal lymphoma. Case: A 8-month-old male neutered mixed-breed cat was referred to the Veterinary Medical Teaching Hospital (HVU) of the UFSM with acute, non-progressive paraplegia. On neurological examination, the patient was paraplegic with no nociception, normal spinal reflexes, increased muscle tone in the pelvic limbs, absence of cutaneous trunci reflex, and spinal hyperesthesia between T13-L1, demonstrating injury in the T3-L3 spinal cord segment. The differential diagnoses included acute spinal cord trauma, neoplasm (lymphoma), and infectious diseases. Hemogram showed lymphocytosis (8062/µL); the biochemical examinations were unremarkable. Tests for antibodies against feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) antigens were negative. Simple radiography, abdominal ultrasonography, and cerebrospinal fluid findings were also normal. Myelography showed left dorsolateral extradural spinal cord compression from T12 to L1. Based on these findings, the presumptive diagnosis was spinal lymphoma and chemotherapy was initiated. After 2 days, the animal began to show hyporexia, adipsia, vomiting, and diarrhea, in addition to an increase in subcutaneous volume in the thoracolumbar region. Antibiotic therapy was initiated; however, the patient died. Necropsy revealed an abscess in the left dorsolateral extradural space at T12-T13 and T13-L1. Bacterial cultures revealed the presence of Neisseria spp. that was resistant to various antibiotics. On the basis of these findings, the animal was diagnosed with SEE. Discussion: This case report aims to inform veterinarians about the diagnosis of SEE. SEE is a rare condition in cats compared to spinal lymphoma; however, their presentation is similar. Even in imaging examinations, such as magnetic resonance imaging, it is not possible to differentiate between these 2 conditions. The evolution of clinical signs made the diagnosis of the present case difficult since it was acute and not progressive. All cases of SEE reported in the literature were progressive, acute, or chronic. Although testing for FeLV was negative, only 56% of cats with spinal lymphoma test positive for this virus. Clinical signs reported by the owner after the start of chemotherapy may be related to adverse effects, such as immunosuppression, which led to worsening of the condition, culminating in the appearance of a subcutaneous abscess. Subsequently, SEE was suspected; however, surgical decompression was not performed as the animal died soon after. The authors of this report reinforce the need for a definitive and non-presumptive diagnosis of spinal lymphoma to initiate chemotherapy because it mimics different neoplasms and non-neoplastic diseases, such as SEE. Surgical removal of the compressive mass in the spinal cord and histopathological analyses are necessary.

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The interlocking nail represents an excellent option as a surgical approach to treat fractures in long bones in veterinary medicine. However, failures were reported mainly due to a slack present in the interface of the rod with the screws. The present study tested and mechanically compare axial compression loads of two novel models of stable angle interlocking nails with threaded holes. Among the two models, one was uniplanar and the other was multiplanar with orthogonally arranged distal holes. Twenty-one specimens made of polylactic acid were used for the implantation of interlocking nail´s rods, divided into three groups: conventional interlocking nail (G1), novel interlocking nail with a stable angle with holes arranged in a single plane (G2), and novel interlocking nail with a stable angle in two planes, with the penultimate hole at 90 degrees from the others (G3). Biomechanical tests were performed using axial, cyclic, and destructive compression load for comparison between them. All the specimens showed plastic deformation in the screws after destructive tests, in both proximal and distal sides, being highly intense in G1. G2 and G3 of the stable angle rods supported higher loads than G1 in all tests performed (P<0.05). The novel stems did not differ statistically from each other (P>0.05). The initial hypothesis that the novel models would provide increased stability was confirmed; however, no differences were demonstrated between them. The screw locking system on the rods allowed high resistance values in the tests performed, proving to be effective and potentially applicable in real clinical situations.

A haste intramedular bloqueada representa excelente opção para abordagem cirúrgica de fraturas em ossos longos na medicina veterinária. Todavia, falhas decorrentes principalmente de "folga" presente na interface da haste com os parafusos foram relatadas. O presente estudo teve como objetivo testar e comparar mecanicamente, por cargas de compressão axial, dois novos modelos de haste intramedular bloqueada de ângulo estável com orifícios roscados, sendo uma delas uniplanar e outra multiplanar com orifícios distais dispostos ortogonalmente. Vinte e um corpos de prova confeccionados em ácido polilático (PLA) foram utilizados para implantação das hastes intramedulares bloqueadas, divididos em três grupos: Haste bloqueada convencional (G1); haste bloqueada nova de ângulo estável com orifícios dispostos em único plano (G2); haste bloqueada nova de ângulo estável em dois planos, com o penúltimo orifício em 90 graus dos demais (G3). Utilizou-se ensaios biomecânicos por carga de compressão axial, cíclicos e destrutivos, para comparação entre eles. Todos mostraram deformação plástica nos parafusos após testes destrutivos, tanto proximais como distais, sendo mais intensa no grupo 1. Os grupos 2 e 3 das hastes de ângulo estável suportaram cargas superiores em relação ao G1 em todos os testes realizados (P<0.05). As hastes novas não diferiram estatisticamente entre si (P>0,05). A hipótese inicial de que os novos modelos proporcionariam maior estabilidade foi confirmada, entretanto não foi demonstrada diferenças entre eles. O sistema de bloqueio roscado dos parafusos nas hastes permitiu valores elevados de resistência nos testes realizados, mostrando-se efetivo e, potencialmente aplicável em situações clínicas reais.

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Intervertebral disc extrusion (IVDE) is the most common cause of spinal cord compression in dogs, whose prognosis is variable and depends on several factors, with deep pain perception (DPP) being the main parameter used. Investigations of new prognostic factors are studied to assist in the estimation of functional recovery. Thus, this study aimed to evaluate whether spinal hyperesthesia (SH) at the compression site can be used as a prognostic factor for the functional recovery of dogs with acute IVDE (Hansen type I), without DPP being subjected to thoracolumbar hemilaminectomy. Decompression surgery was performed on the same day or the day after admission. The duration of the loss of DPP until surgery performance ranged from 1 to 60 days, with a median of 4.5 days for the group of dogs with SH and 5.5 days for those without SH. Among the 68 dogs included in this retrospective study, 73.5% (50/68) showed SH, and 26.5% (18/68) were not identified. Recovery was satisfactory in 60% (30/50) of dogs with SH and in 27.7% (5/18) of dogs without SH, demonstrating that paraplegic dogs without DPP but with SH were 3.9 times more likely to recover when compared to dogs in the same condition, but with no SH. No studies have evaluated SH by palpation of the spine as a prognostic factor, which reinforces the relevance of the present study. The results of this study imply that SH in paraplegic dogs affected by thoracolumbar IVDE, without the presence of DPP, can be used as a possible prognostic indicator of functional recovery.

A extrusão do disco intervertebral (EDIV) é a causa mais comum de lesão compressiva na medula espinhal de cães, cujo prognóstico é variável e depende de diversos fatores, sendo a percepção de dor profunda (PDP) o principal parâmetro utilizado. Pesquisas de novos fatores prognósticos são estudados com intuito de auxiliar na estimativa mais precisa de recuperação funcional. Com isso, o objetivo do estudo foi avaliar se a hiperestesia espinhal (HE) no local da compressão, pode ser utilizada como um fator prognóstico para recuperação funcional de cães com extrusão aguda do disco intervertebral (Hansen tipo I), sem a presença de PDP submetidos a hemilaminectomia toracolombar. A cirurgia descompressiva ocorreu no mesmo dia ou no dia seguinte ao atendimento. A duração da perda de dor profunda até a realização da cirurgia variou de 1 a 60 dias, com uma mediana de 4,5 dias para o grupo de cães com e 5,5 dias para aqueles sem hiperestesia espinhal. Dos 68 cães incluídos nesse estudo retrospectivo, 73,5% (50/68) apresentavam HE e, em 26,5% (18/68) a dor não foi identificada. A recuperação foi satisfatória nos cães com HE em 60% (30/50) e, sem HE, em 27,7% (5/18) dos casos, demonstrando que os cães paraplégicos sem PDP, mas com presença de hiperestesia espinhal tem 3,9 vezes mais chances de recuperação quando comparado com cães na mesma condição, mas sem HE. Não foram encontrados trabalhos que avaliaram a HE mediante a palpação da coluna vertebral como um fator prognóstico, o que reforça a relevância do presente estudo. Os resultados do presente trabalho sugerem que a HE em cães paraplégicos acometidos por EDIV toracolombar sem presença de PDP pode ser utilizada como um possível indicador prognóstico de recuperação funcional.

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Background: Enostosis like lesions are characterized by areas of intramedullary sclerosis affecting the long bones andtheir presence in any cases may be not associated with lameness. It has a migratory characteristic and, therefore there isthe occurrence of lameness at different sites from the initial lesion. Its etiology is speculative and has been attributed tointraosseous increased pressure, of Havers’ canals compression, stimulation of unmyelinated fibers and circulating plateletaggregates. Diagnosis is made through nuclear scintigraphy and associated with radiographic examination. This paperaims to report a clinical case on the use of scintigraphy for the reference diagnosis of enostosis-type injury and treatmentthrough surgical bone decompression.Case: A 2-year-old thoroughbred mare, weighing 483 kg, with a history of acute lameness of the left pelvic limb associatedwith the no previous signs of trauma and no noteworthy changes in radiographic and ultrasound images, was referred to theHorse Center Veterinary Clinic. In the examination of the locomotor system, the animal presented a 2/5 degree lamenessin a straight line, with accentuated exacerbation of the same after flexion of the left femoro-tibio-patellar joint. In addition,presented a reduction in the caudal phase of the stride and croup asymmetry associated with mild myopenia. The findingsof the scintigraphic exam characterized by intense focal area of hyperconcentration of medullary radiopharmaceutical inthe proximal third of the right third metatarsal, and multiple areas of hyperconcentration in the aspect proximal to thedistal third of the left tibia. In the radiographic images, multifocal radiopaque regions that coincided with the areas ofradiopharmaceutical hyperconcentration were observed. The initial treatment was based on rest, use of non-steroidal antiinflammatory drugs and acetylsalicylic acid. In the 60 days...

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Dorsal laminectomy is routinely performed for spinal cord compressions or stenosis of the cervical vertebral canal. However, despite good results, relevant complications have been described in dogs. Considering the incomplete understanding of the necessity for complementary surgical stabilization after performing laminectomies in the cervical region, this study compared the resistance and range of motion (ROM) of the cervical spinal column subjected to Funkquist B laminectomy between the sixth and seventh vertebrae in dogs. Forty-four cervical vertebral columns (C2-T1) of dogs, with an average weight of 26.2±3.8 kg, were selected using radiography and computed tomography. Four experimental groups (n=11) were established according to the mechanical test: two control groups (flexion and extension control) and two laminectomy groups (flexion and extension laminectomies). Numerical results of the maximum load for measuring the resistance and ROM of the columns of the two control groups and the two laminectomy groups were compared. The laminectomy groups showed a lower maximum load, regardless of the mechanical test performed (P<0.001). The ROM was not influenced by laminectomy, the type of mechanical test (ventral flexion or extension), or its interaction (P<0.05). There was no interaction between the effect of the laminectomy factors (yes or no) and the effect of the mechanical tests for ventral flexion or extension (P<0.05). In conclusion, Funkquist B dorsal cervical laminectomy between C6 and C7 decreases mechanical resistance with a supraphysiological loading force but does not alter the ROM, suggesting that it can be used without additional mechanical stabilization in dogs.

A laminectomia dorsal é realizada com frequência no tratamento de compressões medulares ou estenose do canal vertebral cervical. No entanto, complicações relevantes têm sido descritas em cães. Considerando que ainda não há entendimento completo da necessidade de estabilização cirúrgica complementar após a realização de uma ou múltiplas laminectomias na região cervical, o objetivo deste estudo foi comparar a resistência e amplitude de movimento (ADM) da coluna cervical submetida à laminectomia Funkquist B entre a sexta e a sétima vértebras em cães. Quarenta e quatro colunas vertebrais cervicais (C2-T1) de cães, com peso médio de 26,2 ± 3,8 kg, foram selecionadas por meio de radiografia e tomografia computadorizada. Quatro grupos experimentais (n = 11) foram estabelecidos de acordo com o teste mecânico realizado: dois grupos controle (flexão e extensão controle) e dois grupos laminectomia (flexão e extensão laminectomia). Os resultados numéricos da carga máxima para medir a resistência e ADM das colunas dos dois grupos de controle e dos dois grupos de laminectomia foram comparados. Os grupos de laminectomia apresentaram menores valores de carga máxima, independentemente do teste mecânico realizado (P < 0,001). A ADM não foi influenciada pela laminectomia, tipo de teste mecânico (flexão ou extensão ventral) ou sua interação (P < 0,05). Não houve interação entre o efeito do fator de laminectomia, sim ou não, ou o efeito do teste mecânico na flexão ou extensão ventral (P < 0,05). A laminectomia cervical dorsal Funkquist B entre C6 e C7 diminui a resistência mecânica com uma força de carga suprafisiológica, mas não altera a ADM, sugerindo que pode ser usada sem estabilização mecânica adicional em cães.

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For vertebromedullary injuries, epidemiological knowledge is essential to guide the choice of the most effective diagnostic method. The objective of this retrospective study was to describe the epidemiological profile of animals and thoracolumbar and lumbosacral spine lesions diagnosed by computed tomography scan. A compilation of CT scan reports for the aforementioned regions performed in a comercial diagnostic center from 04/01/2017 to 04/30/2020, contrasted and non-contrasted, from routine, was performed in order to list the most common lesions and their locations, as well as the species, breeds and ages most affected. There were 1164 CT scans performed in the period evaluated, all of them in dogs, 57,56% (n=670) for the spine, with 89,7% reports accessed (n=601), where the regions mentioned here added up to 73,05% studies (n=439). In both regions, male French Bulldog dogs had the most injuries. For the thoracolumbar region, disk mineralization, followed by extrusion, were the most frequent injuries, while the site was T12-13 and the mean age 6,5±3,63 years old. In the lumbosacral, disk protrusion was most frequent, the most affected site was L7-S1 and age 6,65±3,79 years. It was concluded that the spine is the main target of CT scans, and that lesions related to the intervertebral disk were the main ones identified, with chondrodystrophic animals being more predisposed to injury.

Para lesões vertebromedulares é indispensável o conhecimento epidemiológico para direcionar a escolha do método diagnóstico mais eficaz. O objetivo desse estudo retrospectivo foi descrever o perfil epidemiológico dos animais e das lesões em coluna vertebral toracolombar e lombossacral diagnosticadas através de exame tomográfico. Realizou-se a compilação de laudos de tomografias computadorizadas para as referidas regiões realizadas em centro diagnóstico comercial, entre 01/04/2017 a 30/04/2020, contrastadas e não-contrastadas, provenientes da rotina, a fim de relacionar as lesões e seus locais de ocorrência, bem como a espécie, raças e idades mais comuns. Foram realizados 1164 exames tomográficos no período avaliado, sendo 57,56% (n=670) para a coluna, com 89,7% laudos acessados (n=601), nos quais as regiões toracolombar e lombossacral somaram 73,05% dos estudos (n=439). Em ambas as regiões, os cães Bulldog Francês machos foram os que mais apresentaram lesões. Para a região toracolombar, a mineralização de disco, seguida pela extrusão, foram as lesões mais frequentes, enquanto o local foi T12-13 e a média de idade 6,5±3,63 anos. Na lombossacral, a protusão de disco foi mais frequente, o local mais afetado foi L7-S1 e idade de 6,65±3,79 anos. Concluiu-se que a coluna vertebral é o principal alvo de tomografias, e que as lesões relacionadas ao disco intervertebral foram as principais identificadas, sendo os animais condrodistróficos mais predispostos a lesões.

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Injuries involving the spine are frequent in dogs and knowledge of them is important to define the patient's treatment and prognosis. The objective of this retrospective study was to describe the epidemiological profile of animals and lesions in the cervical (C1-5) and cervicothoracic (C6-T2) spine diagnosed through tomographic examination. Compilation of computed tomography (CT) reports for the referred regions was carried out in a diagnostic center between 01/04/2017 and 30/04/2020, with or without contrast, from the clinical routine, in order to relate the most common lesions and their locations, as well as the species, breeds and ages most affected. A total of 1164 CT scans were performed in the period, 57.56% (n=670/1164) for the spine, with 89.7% (n=601/670) reports accessed, where both regions referred to here totaled 26.95% of the studies (n=162/601). Male mixed-breed dogs (MBD) showed the most lesions. For the cervical spine, the most identified lesion was disk extrusion and the site was C3-C4, while the mean age for lesions was 8.09±3.55 years. As for cervicothoracic, disk mineralization was more frequent and the mean age for lesions was 6.96±2.93 years. It was concluded that the spine is the main target of CT scans, that lesions related to the intervertebral disk were the main ones identified, and older MBD animals are the main ones affected.

As lesões envolvendo coluna vertebral são frequentes em animais de companhia, podendo ocorrer à nível vertebral, medula espinal, disco intervertebral, meninges ou raízes nervosas, e o conhecimento das mesmas é importante para definir o tratamento e prognóstico do animal. O objetivo desse estudo retrospectivo foi descrever o perfil epidemiológico dos animais e das lesões em coluna vertebral cervical (C1-5) e cervicotorácica (C6-T2) diagnosticadas por meio de exame tomográfico. Realizou-se a compilação de laudos de tomografias computadorizadas para as referidas regiões realizadas em centro diagnóstico comercial, entre 01/04/2017 a 30/04/2020, contrastadas e não-contrastadas, provenientes da rotina clínica, a fim de relacionar as lesões, raças e locais mais comuns. Foram realizados 1164 exames tomográficos no período avaliado, sendo 57,56% (n=670/1164) para a coluna, com 89,7% dos laudos acessados (n=601/670), sendo que as regiões cervical e cervicotorácica somaram 26,95% dos estudos (n=162/601). Em ambas regiões, os cães sem raça definida (SRD) machos foram os que mais demonstraram lesões. Para a coluna cervical, a lesão mais identificada foi extrusão de disco e o local mais afetado foi C3-C4, enquanto a média de idade para lesões foi 8,09±3,55 anos. Já para cervicotorácica, a mineralização de disco foi mais frequente e média de idade para ocorrência de lesões foi de 6,96±2,93 anos. Concluiu-se que a coluna vertebral foi o principal alvo de tomografias, as lesões relacionadas ao disco intervertebral foram as mais identificadas, sendo animais SRD com idade avançada os mais acometidos.

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El osteosarcoma es una de las neoplasias óseas más comúnmente reportadas en medicina veterinaria, principalmente en perros de raza grande y gigante, siendo que la forma vertebral tiene importante escenario clínico presentando el 5% del total de reportes. Tiene un pronóstico desfavorable y un tiempo de supervivencia corto. La presentación clínica es variable y pueden observarse desde signos de dolor intenso hasta déficits neurológicos como resultado de la afectación medular progresiva. El diagnóstico puede realizarse mediante imágenes con radiografía o tomografía computarizada, y mediante análisis de laboratorio de citopatología o histopatología, siendo este último preferible para la clasificación del tumor. La resección parcial del tumor es una forma de tratamiento paliativo, indicada en algunos casos para aliviar temporalmente los signos clínicos relacionados con el dolor y los déficits neurológicos. Sin embargo, cuando hay posibilidad terapéutica, la escisión completa proporciona un mejor pronóstico y tiempo de supervivencia, principalmente cuando se asocia con quimioterapia o radioterapia. Mediante el procedimiento de la vertebrectomía, es necesaria la estabilización quirúrgica, que puede realizarse respetando los principios para la estabilización vertebral por traumatismo, siendo necesaria la colocación de un espaciador vertebral para evitar el colapso medular. Se han propu

Osteosarcoma is one of the most commonly reported bone neoplasms in veterinary medicine, especially in large and giant breed dogs, and the vertebral form has an important clinical scenario presenting 5% of the total reports. This has an unfavorable prognosis and a short survival time.  The clinical presentation is variable and signs of severe pain to neurological deficits can be observed as a result of progressive spinal cord involvement. The diagnosis can be made by imaging with radiography or computed tomography, and by laboratory analysis of cytopathology or histopathology, the latter being preferable for tumor classification. Partial tumor resection is a palliative form of treatment, indicated in some cases to temporarily relieve clinical signs related to pain and neurological deficits. However, when there is therapeutic possibility, complete excision provides better prognosis and survival time, especially when associated with chemotherapy or radiotherapy. Through the vertebrectomy procedure, surgical stabilization is necessary and can be performed following the principles for vertebral stabilization due to trauma, with the placement of a vertebral spacer being necessary to prevent spinal collapse. Several materials have been proposed for the manufacture of the spinal spacer. Additive manufacturing, also known as 3D printing, has transformed the concept of rapid pr

O osteossarcoma é uma das neoplasias ósseas mais comumente relatadas na medicina veterinária, principalmente em cães de raça grande e gigante, sendo que a forma vertebral possui importante cenário clínico apresentando 5% do total de relatos. Este possui um prognóstico desfavorável e tempo de sobrevida pequeno. A apresentação clínica é variável e podem ser observados sinais de dor intensa a déficits neurológicos em decorrência do envolvimento medular progressivo. O diagnóstico pode ser realizado por imagens através de radiografia ou tomografia computadorizada, e por análises laboratoriais de citopatologia ou histopatologia, sendo o último preferível para classificação de tumores. A ressecção tumoral parcial é uma forma paliativa de tratamento, indicada em alguns casos para aliviar temporariamente os sinais clínicos relacionados a dor e déficits neurológicos. Contudo, quando há possibilidade terapêutica, a excisão completa fornece melhor prognóstico e tempo de sobrevida, principalmente quando associada a quimioterapia ou radioterapia. Mediante procedimento de vertebrectomia, a estabilização cirúrgica é necessária, podendo ser realizada respeitando os princípios para estabilização vertebral por trauma, sendo necessário a colocação de um espaçador vertebral para evitar o colabamento medular. Diversos materiais foram propostos para a confecção do espaçador vertebral. A manufatura ad

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O osteossarcoma é uma das neoplasias ósseas mais comumente relatadas na medicina veterinária, principalmente em cães de raça grande e gigante, sendo que a forma vertebral possui importante cenário clínico apresentando 5% do total de relatos. Este possui um prognóstico desfavorável e tempo de sobrevida pequeno. A apresentação clínica é variável e podem ser observados sinais de dor intensa a déficits neurológicos em decorrência do envolvimento medular progressivo. O diagnóstico pode ser realizado por imagens através de radiografia ou tomografia computadorizada, e por análises laboratoriais de citopatologia ou histopatologia, sendo o último preferível para classificação de tumores. A ressecção tumoral parcial é uma forma paliativa de tratamento, indicada em alguns casos para aliviar temporariamente os sinais clínicos relacionados a dor e déficits neurológicos. Contudo, quando há possibilidade terapêutica, a excisão completa fornece melhor prognóstico e tempo de sobrevida, principalmente quando associada a quimioterapia ou radioterapia. Mediante procedimento de vertebrectomia, a estabilização cirúrgica é necessária, podendo ser realizada respeitando os princípios para estabilização vertebral por trauma, sendo necessária a colocação de um espaçador vertebral para evitar o colabamento medular. Diversos materiais foram propostos para a confecção do espaçador vertebral. A manufatura aditiva, também conhecida como impressão 3D, tem transformado o conceito de prototipagem rápida em realidade, devido a habilidade de fabricar peças geométricas específicas de alta complexidade e de forma rápida, permitindo elaborar protótipos para uso pré ou transoperatórios em cirurgias ortopédicas de alta complexidade. O polietileno tereftalato glicol (PETG), por ser um termoplástico de alta resistência, não-biodegradável, biocompatível e de baixo custo é foco desse trabalho no desenvolvimento do espaçador vertebral como estabilizador em um procedimento de vertebrectomia em cão.

Osteosarcoma is one of the most commonly reported bone neoplasms in veterinary medicine, especially in large and giant breed dogs, and the vertebral form has an important clinical scenario presenting 5% of the total reports. This has an unfavorable prognosis and a short survival time. The clinical presentation is variable and signs of severe pain to neurological deficits can be observed as a result of progressive spinal cord involvement. The diagnosis can be made by imaging with radiography or computed tomography, and by laboratory analysis of cytopathology or histopathology, the latter being preferable for tumor classification. Partial tumor resection is a palliative form of treatment, indicated in some cases to temporarily relieve clinical signs related to pain and neurological deficits. However, when there is therapeutic possibility, complete excision provides better prognosis and survival time, especially when associated with chemotherapy or radiotherapy. Through the vertebrectomy procedure, surgical stabilization is necessary and can be performed following the principles for vertebral stabilization due to trauma, with the placement of a vertebral spacer being necessary to prevent spinal collapse. Several materials have been proposed for the manufacture of the spinal spacer. Additive manufacturing, also known as 3D printing, has transformed the concept of rapid prototyping into reality, due to its ability to quickly manufacture specific geometric parts of high complexity, allowing the elaboration of prototypes for pre- or trans-operative use in highly complex orthopedic surgeries. Polyethylene terephthalate glycol (PETG), being a high-strength, non-biodegradable, biocompatible and low-cost thermoplastic, is the focus of this work in the development of the vertebral spacer as a stabilizer in a vertebrectomy procedure in a dog.

El osteosarcoma es una de las neoplasias óseas más comúnmente reportadas en medicina veterinaria, principalmente en perros de raza grande y gigante, siendo que la forma vertebral tiene importante escenario clínico presentando el 5% del total de reportes. Tiene un pronóstico desfavorable y un tiempo de supervivencia corto. La presentación clínica es variable y pueden observarse desde signos de dolor intenso hasta déficits neurológicos como resultado de la afectación medular progresiva. El diagnóstico puede realizarse mediante imágenes con radiografía o tomografía computarizada, y mediante análisis de laboratorio de citopatología o histopatología, siendo este último preferible para la clasificación del tumor. La resección parcial del tumor es una forma de tratamiento paliativo, indicada en algunos casos para aliviar temporalmente los signos clínicos relacionados con el dolor y los déficits neurológicos. Sin embargo, cuando hay posibilidad terapéutica, la escisión completa proporciona un mejor pronóstico y tiempo de supervivencia, principalmente cuando se asocia con quimioterapia o radioterapia. Mediante el procedimiento de la vertebrectomía, es necesaria la estabilización quirúrgica, que puede realizarse respetando los principios para la estabilización vertebral por traumatismo, siendo necesaria la colocación de un espaciador vertebral para evitar el colapso medular. Se han propuesto varios materiales para la fabricación del espaciador vertebral. La fabricación aditiva, también conocida como impresión 3D, ha transformado el concepto de prototipado rápido en una realidad, debido a la capacidad de fabricar piezas geométricas específicas de gran complejidad y con rapidez, lo que permite la elaboración de prototipos para su uso pre o trans-operatorio en cirugías ortopédicas de gran complejidad. El polietileno tereftalato glicol (PETG), por ser un termoplástico de alta resistencia, no biodegradable, biocompatible y de bajo costo es el foco de este trabajo en el desarrollo del espaciador vertebral como estabilizador en un procedimiento de vertebrectomía en un perro.

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Background: Coxofemoral dislocation is uncommon in large animals, due to anatomical particularities that provide greater stability to this joint. The most common causes of hip dislocation in large animals are related to hypocalcemia, mount trauma, sudden falls on hard surfaces or dystocia. Treatment can be performed by closed reduction, but the reported results are not satisfactory with complications. Several surgical techniques have already been described and successfully used in small animals in the treatment of hip dislocation. The present work aims to describe the technique and the result of the iliofemoral suture in the treatment of hip dislocation in a Girolando heifer. Case: A heifer was attended with a history of difficulty in getting up. According to the owner, the clinical manifestation was sudden, after remaining in a paddock with other animals of different age groups. The calf had reduced skin sensitivity on the croup, and it was impossible to remain in the quadrupedal position, often remaining in sternal recumbency with the left pelvic limb in extension. From the clinical examination, spinal cord injury was suspected and clinical treatment was instituted with dexamethasone, vitamins B1, B12 and dimethylsulfoxide. At the end of the clinical treatment, the animal did not show a favorable evolution, so radiographic examination of the coxofemoral region was performed, revealing dislocation of the left femoral head, indicating surgical correction. Xylazine was administered as pre-anesthetic medication, followed by anesthetic induction with midazolam associated with ketamine, followed by orotracheal intubation. Anesthetic maintenance was instituted with isoflurane and monitoring was performed with a multiparameter monitor. An epidural block was performed with bupivacaine and morphine. A craniolateral approach to the left hip joint was performed. After the dislocation was reduced, sutures were used to better stabilize the joint in question. Following the evolution of the surgical procedure, it was possible to confirm that the femoral head remained in place. After 15 days, the skin stitches were removed and the animal was discharged from the hospital and returned to its original property. The calf was asked to remain in the stall for at least 60 days, gradually releasing it into larger spaces and only after 120 days could it remain in the paddock with other animals. During three months, the tutor was consulted about the evolution of the condition, reporting that the animal was clinically well, being able to get up and walk without difficulty and with a mild degree of lameness, thus suggesting the success of the surgical procedure. Discussion: There are few studies of successful surgical treatments of hip dislocation in large animals, and that number is even smaller when considering cattle alone. It is believed that this is due to difficulties related to the surgical technique and to postoperative handling, given the animal's weight. The iliofemoral suture technique performed on the animal in the present study is commonly employed in small animals, and excellent results have been observed. However, reports on the use of this technique in large animals have not been found. The iliofemoral suture technique has advantages over other reported surgical techniques in cattle. When compared to the femoral head and neck resection, the iliofemoral suture has several advantages, as it allows preservation of the joint and achievement of superior biomechanical results. When compared to the technique of reinforcement of the joint capsule with synthetic material, also reported in cattle, the iliofemoral suture appears to be faster, simpler and more economic, and provides similar stability. We conclude that the iliofemoral suture proved to be a satisfactory alternative for the treatment of hip dislocations in young cattle.

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As lesões decorrentes de atropelamento são as principais causas de fraturas e luxações vertebrais, ocasionando graus variáveis de injúrias vertebrais e medulares. O presente trabalho tem como objetivo relatar a ocorrência de lesão traumática em coluna vertebral de cão sem raça definida, com quatro anos de idade, resultando em luxação T11-12, com exposição de T11 e secção medular, estando o paciente paraplégico, com sinais de lesão em neurônio motor superior e ausência de nocicepção profunda em membros pélvicos. O tratamento de escolha foi a vertebrectomia de T11, associada ao alinhamento de T10-12 com introdução de pinos e fixação com polimetilmetacrilato (PMMA) associado à ceftriaxona. Em decorrência de lesão na pleura parietal no trans-cirúrgico, optou-se pela toracostomia para introdução de tubo torácico, o qual permaneceu no paciente por quatro dias. No pós-operatório, o paciente apresentou recuperação satisfatória, sendo recomendado aos tutores a confecção de cadeira de rodas a fim de facilitar sua locomoção. A técnica mostrou-se satisfatória para minimizar as infecções passíveis de ocorrência em fraturas expostas, bem como melhorar a qualidade de vida do paciente, evitando-se dores crônicas.

Injuries resulting from being run over are the leading causes of vertebral fractures and dislocations, causing varying vertebral and spinal injuries. The present study aims to report the occurrence of traumatic injury to the spine of a mixed breed dog, aged four years, resulting in a T11-12 dislocation, with T11 exposure and spinal section, with the patient showing paraplegia, signs of an upper motor neuron lesion and absence of deep nociception in pelvic limbs. The treatment of choice was T11 vertebrectomy, associated with the alignment of T10-12 with the introduction of pins and fixation with polymethylmethacrylate (PMMA) associated with ceftriaxone. Due to a lesion in the parietal pleura during the surgery, thoracostomy was chosen to introduce a chest tube, which remained in the patient for four days. In the postoperative period, the patient presented a satisfactory recovery, and it was recommended that tutors make a wheelchair to facilitate their mobility. The technique proved to be satisfactory for minimizing infections that could occur in open fractures and improving the patient's quality of life, avoiding chronic pain.

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ABSTRACT Purpose To probe the mechanism of mild hypothermia combined with rutin in the treatment of spinal cord injury (SCI). Methods Thirty rats were randomized into the following groups: control, sham, model, mild hypothermia (MH), and mild hypothermia plus rutin (MH+Rutin). We used modified Allen's method to injure the spinal cord (T10) in rats, and then treated it with MH or/and rutin immediately. BBB scores were performed on all rats. We used HE staining for observing the injured spinal cord tissue; ELISA for assaying TNF-α, IL-1β, IL-8, Myeloperoxidase (MPO), and Malondialdehyde (MDA) contents; Dihydroethidium (DHE) for measuring the reactive oxygen species (ROS) content; flow cytometry for detecting apoptosis; and both RT-qPCR and Western blot for determining the expression levels of TGF-β/Smad pathway related proteins (TGF-β, Smad2, and Smad3). Results In comparison with model group, the BBB score of MH increased to a certain extent and MH+Rutin group increased more than MH group (p < 0.05). After treatment with MH and MH+Rutin, the inflammatory infiltration diminished. MH and MH+Rutin tellingly dwindled TNF-β, MDA and ROS contents (p < 0.01), and minified spinal cord cell apoptosis. MH and MH+Rutin could patently diminished TGF-β1, Smad2, and Smad3 expression (p < 0.01). Conclusions MH+Rutin can suppress the activation of TGF-β/Smad pathway, hence repressing the cellular inflammatory response after SCI.

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ABSTRACT Purpose To investigate the effect of ferulic acid (FA) on spinal cord injury (SCI)-induced motor dysfunction and to explore the possible pharmacological mechanisms. Methods Adult male Wistar rats were used in our study. SCI was achieved by clipping the spinal cord T9 of the rat by a vascular clip for 2 minutes. The motor function of the rat was evaluated by Basso, Beattie, and Bresnahan scoring method (BBB) and inclined plane test. Hematoxylin and eosin (HE) staining, NISSL staining, and transmission electron microscopic examination were used to evaluate alterations at the histological level. Polymerase chain reaction (PCR), Western blots, and enzyme-linked immunosorbent assays (ELISA) were employed in biochemical analysis. Results The BBB score and inclined plane test score significantly decreased after SCI surgery, whereas chronic FA treatment (dose of 90 mg/kg, i.g.) for 28 days improved SCI-induced motor dysfunction. HE staining showed that SCI surgery induced internal spinal cord edema, but the structural changes of the spinal cord could be reversed by FA treatment. NISSL staining and transmission electron microscopic examination confirmed the improvement of the effect of FA on the injury site. In the biochemical analysis, it could be found that FA inhibitedSCI-induced mRNA and protein overexpression of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), as well as iNOS and COX-2 via the modulation of NF-κB level in the spinal cord of SCI rat. Moreover, the SCI-induced decrease of Bcl-2/Bax ratio was also reversed by FA treatment. However, the effect of FA on the expression of Beclin-1 was not statistically significant. Conclusions FA showed a therapeutic effect on SCI, which may be associated with the regulation of neuroinflammation and apoptosis.

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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...

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Background: Acute spinal traumas can lead to irreversible damage associated with vascular and inflammatory changes in neural tissue. Since spine and spinal cord traumas have an unfavorable prognosis in small animals, and reports of the use of Steinmann pins and polymethylmethacrylate repair of lumbar vertebra fracture-luxation in puppies are rare in the literature, the present paper aimed to report the surgical treatment of transversal fracture through the body of the fourth lumbar vertebra, with dorsocranial displacement of the caudal fragment by using Steinmann pins and polymethylmethacrylate in a 7-month-old Labrador Retriever male dog. Case: A 7-month-old intact male Labrador Retriever dog, weighing 24.0 kg was attended at School Veterinary Hospital with a history of hit by car and paraplegia of the hind limbs. On neurological examination was observed no proprioception and no deep pain sensitivity on the both pelvic limbs. The lumbar spinal palpation showed intense pain, and the motor function and patellar reflexes were reduced. The values of haematological and biochemical analysis remained within the reference values for the species. Radiographs revealed a transversal fracture through the body of the fourth lumbar vertebra, with dorsocranial displacement of the caudal fragment, and was decided to perform a surgical treatment by open reduction and internal fixation of the fracture. The dog was positioned in ventral recumbency for surgery, and a dorsal midline incision was made from the second lumbar vertebra to the sixth lumbar vertebra. Two crossed 1.5 mm Kirschner wires were placed through the caudal articular facets of the fourth lumbar vertebra to provide initial stability...

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O objetivo deste estudo foi avaliar o efeito da ω-conotoxina MVIIC e das células-tronco mesenquimais (CTM) de forma isolada e sua associação nos ratos submetidos ao trauma medular agudo (TMA). Trinta Rattus novergicus, linhagem Wistar, três meses de idade, foram distribuídos igualmente em cinco grupos experimentais: controle negativo (CN), controle positivo (CP), ω-conotoxina MVIIC (MVIIC), células-tronco mesenquimais da medula óssea (CTM-MO) e associação (MVIIC + CTM-MO). O grupo CN foi submetido à laminectomia sem trauma medular, e os grupos CP, MVIIC, CTM-MO e MVIIC + CTM-MO foram submetidos ao trauma medular contusivo. O grupo CP recebeu, uma hora após o TMA, 10µL de PBS estéril, e os grupos MVIIC e MVIIC + CTM-MO receberam 10µL de PBS contendo 20pmol da ω-conotoxina MVIIC, todos por via intratecal. Os grupos CTM-MO e MVIIC + CTM-MO receberam, 24 horas após, 1x106 de CTM via intravenosa. Avaliou-se a recuperação da função locomotora até o sétimo dia pós-trauma. Os animais tratados com MVIIC + CTM-MO obtiveram recuperação motora após o trauma medular agudo (P<0,05). Conclui-se que essa associação apresentou efeito neuroprotetor com melhora na função locomotora em ratos Wistar.(AU)

The objective of this study was to evaluate the effect of isolated ω-conotoxin MVIIC and mesenchymal stem cells (MSCs) and its association in rats submitted to acute spinal cord injury (SCI). Thirty Rattus norvegicus, Wistar strain, three-month-old rats were randomly distributed in five experimental groups with six animals: negative control (CN), positive control (CP), ω-conotoxin MVIIC (MVIIC), bone marrow mesenchymal stem cells (CTM-MO) and the association (MVIIC + CTM-MO). The CN group underwent laminectomy without spinal cord trauma, and groups CP, MVIIC, CTM-MO and MVIIC + CTM-MO were submitted to contusive spinal cord trauma. The CP group received 10µl of PBS one hour after SCI, and groups MVIIC and MVIIC + CTM-MO received 10µl of PBS containing 20pmol of ω-conotoxin MVIIC, both intrathecally. Groups CTM-MO and MVIIC + CTM-MO received 1x106 of MSCs intravenously 24 hours later. The recovery of locomotor function was evaluated up to seven days post-injury. The animals treated with MVIIC + CTM-MO obtained motor recovery after SCI (P<0.05). It is concluded that this association showed neuroprotective effect with improvements in locomotor function in Wistar rats.(AU)

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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 [...].