Comparison of surgical invasiveness between micro-endoscopic discectomy/microscopic discectomy and conventional hemilaminectomy in dogs.

Micro-endoscopic discectomy (MED) or microscopic discectomy (MD) have been performed for disc herniation in humans. The purpose of this study was to compare the invasiveness of the hemilaminectomy in dogs between the approach using a cylindrical retractor for the MED/MD and a conventional open surgical approaches in dogs. First, as preliminary studies, we analyzed the suitability of the cylindrical retractor for the vertebral body of small to medium-sized dogs on the X-ray computed tomographic images using the three-dimensional analysis software, and confirmed that it was possible to open a bone window of an approximate length of 1.72 clto the spinal canal with the cylindrical retractor with a diameter 17 mm using two medium-sized canine cadavers. Next, to determine difference in the invasiveness of hemilaminectomy, the magnitude of tissue damage, surgical stress and postoperative pain were compared between the conventional open approach (hemilaminectomy group: HL group, n=6) and the surgical approach using the cylindrical retractor (MD group, n=6) in 12 beagle dogs. The plasma creatine phosphokinase, C-reactive protein and cortisol concentrations, incision length and University of Melbourne Pain Scale scores after the hemilaminectomy were significantly lower in the MD group than in the HL group. There were no significant differences between the durations of surgery and the other evaluated indices. The approach using the MD can provide a less invasive hemilaminectomy than the conventional approach in dogs.

Biomechanical effects of a titanium intervertebral cage as a stand-alone device, and in combination with locking plates in the canine caudal cervical spine.

OBJECTIVE: To evaluate the change in ex vivo biomechanical properties of the canine cervical spine, due to an intervertebral cage, both as a stand-alone device and in combination with plates. STUDY DESIGN: Experimental ex vivo study. ANIMALS: Cervical spinal segments (C5-C7) from eight canine cadavers. METHODS: The range of motion (ROM) and elastic zone stiffness (EZS) of the spines were determined with a four-point bending device in flexion/extension, lateral bending, and axial rotation for four conditions: native, discectomy, cage (at C6-C7), and cage with plates (at C6-C7). The disc height index (DHI) for each condition was determined using radiography. RESULTS: Discectomy resulted in overall increased ROM (p < .01) and EZS (p < .05) and decreased DHI (p < .005) when compared to the native condition. Placement of the cage increased DHI (p < .001) and restored total ROM during flexion/extension, lateral bending and axial rotation, and EZS during flexion/extension to the level of the native spine. Application of the plates further reduced the total ROM during flexion/extension (p < .001) and lateral bending (p < .001), but restored ROM in extension and EZS during lateral bending. No implant failure, subsidence, or significant cage migration occurred during loading. CONCLUSION: An anchorless intervertebral cage used as a stand-alone device was able to restore the disc height and spinal stability to the level of the native cervical spine, whereas the addition of plates further reduced the spinal unit mobility. CLINICAL SIGNIFICANCE: This study implies that the intervertebral cage may be used as a stand-alone device in the spinal unit fixation in the canine cervical spine.

Comparison of the biomechanical performance of a customized unilateral locking compression plate with and without an intervertebral spacer applied to the first and second lumbar vertebrae after intervertebral diskectomy in canine cadaveric specimens.

OBJECTIVE: To determine whether a customized unilateral intervertebral anchored fusion device combined with (vs without) an intervertebral spacer would increase the stability of the L1-L2 motion segment following complete intervertebral diskectomy in canine cadaveric specimens. SAMPLE: Vertebral columns from T13 through L3 harvested from 16 skeletally mature Beagles without thoracolumbar disease. PROCEDURES: Complete diskectomy of the L1-2 disk was performed in each specimen. Unilateral stabilization of the L1-L2 motion segment was performed with the first of 2 implants: a unilateral intervertebral anchored fusion device that consisted of a locking compression plate with or without an intervertebral spacer. The resulting construct was biomechanically tested; then, the first implant was removed, and the second implant was applied to the contralateral side and tested. Range of motion in flexion and extension, lateral bending, and torsion was compared among intact specimens (prior to diskectomy) and constructs. RESULTS: Compared with intact specimens, constructs stabilized with either implant were as stable in flexion and extension, significantly more stable in lateral bending, and significantly less stable in axial rotation. Constructs stabilized with the fusion device plus intervertebral spacer were significantly stiffer in lateral bending than those stabilized with the fusion device alone. No significant differences in flexion and extension and rotation were noted between implants. CONCLUSIONS AND CLINICAL RELEVANCE: Findings did not support the use of this customized unilateral intervertebral anchored fusion device with an intervertebral spacer to improve unilateral stabilization of the L1-L2 motion segment after complete L1-2 diskectomy in dogs.

The effects of foraminotomy and intervertebral distraction on the volume of the lumbosacral intervertebral neurovascular foramen: An ex vivo study.

Degenerative lumbosacral stenosis in dogs frequently involves L7-S1 foraminal stenosis and L7 nerve root compression. Surgical techniques to decompress the L7 nerve root include foraminotomy and intervertebral distraction. The objective of this study was to compare the effect of foraminotomy and intervertebral distraction on the total, cranial, and caudal compartmental volumes of the L7-S1 intervertebral neurovascular foramen (NF). CT images were obtained from eight canine lumbosacral (L5-CD1) specimens in the following sequential conditions: native spine (1), after dorsal laminectomy and partial discectomy of L7-S1 (2), after L7-S1 foraminotomy (3), after distraction with an interbody cage between L7 and S1 (4), after cage distraction stabilized with pedicle screw-rod fixation in neutral (5) and flexed position (6). The volume of the complete NF and its cranial and caudal subcompartments were calculated using the CT images and statistically compared between conditions. P < 0.05 was considered statistically significant. The volume of the complete NF was significantly increased after foraminotomy (mean ± standard deviation (146.8 ± 26.5%, P < 0.01) and after distraction (Condition 4, 121.0 ± 19.1%; Condition 5, 116.6 ± 29.3 %; Condition 6, 119.0 ± 21.8 %; P = 0.01) with no difference between the distraction conditions. Foraminotomy induced a significantly larger increase in total NF volume compared to distraction. Foraminotomy, but not distraction, induced a significant increase in volume of the cranial subcompartment (158.2 ± 33.2 %; P < 0.01). Foraminotomy is more effective in increasing the foraminal volume and especially the cranial subcompartment, which is where the L7 nerve root traverses the NF. Hence, foraminotomy may be more effective in decompressing the L7 nerve root.

Comparison between Hemilaminectomy with either Anulectomy or Partial Discectomy for Treatment of Thoracolumbar Intervertebral Disc Protrusion in Dogs.

OBJECTIVES: The aim of this study was to compare the clinical outcome of dogs undergoing a hemilaminectomy with anulectomy (HA) or a hemilaminectomy with partial discectomy (HPD) for treatment of thoracolumbar intervertebral disc protrusion. METHODS: Medical records from 2006 to 2015 were retrospectively reviewed. Dogs were included if they had clinical signs and imaging findings consistent with thoracolumbar intervertebral disc protrusion and had undergone surgical treatment with a HA or HPD. Outcome data were obtained via veterinary records and owner questionnaires. Recorded variables included age, sex, body weight, neurological deficits, surgical time, perioperative complications, postoperative neurological deterioration and recurrence of clinical signs. RESULTS: The two treatment groups showed no significant difference in signalment, clinical presentation and imaging findings. However, significant differences were detected in outcome. Early postoperative neurological deterioration was recorded in 16/29 dogs in the HA group and 7/24 dogs in the HPD group (p = 0.037). Sustained clinical improvement for a minimum of 18 months postoperatively was reported in 9/22 dogs in the HA group compared with 17/23 dogs in the HPD group (p = 0.019). CLINICAL SIGNIFICANCE: Hemilaminectomy with partial discectomy for decompression of thoracolumbar intervertebral disc protrusion was associated with decreased postoperative neurological deterioration and increased sustained clinical improvement compared with hemilaminectomy with anulectomy.

Degenerative changes of the canine cervical spine after discectomy procedures, an in vivo study.

BACKGROUND: Discectomies are a common surgical treatment for disc herniations in the canine spine. However, the effect of these procedures on intervertebral disc tissue is not fully understood. The objective of this study was to assess degenerative changes of cervical spinal segments undergoing discectomy procedures, in vivo. RESULTS: Discectomies led to a 60% drop in disc height and 24% drop in foraminal height. Segments did not fuse but showed osteophyte formation as well as endplate sclerosis. MR imaging revealed terminal degenerative changes with collapse of the disc space and loss of T2 signal intensity. The endplates showed degenerative type II Modic changes. Quantitative MR imaging revealed that over 95% of Nucleus Pulposus tissue was extracted and that the nuclear as well as overall disc hydration significantly decreased. Histology confirmed terminal degenerative changes with loss of NP tissue, loss of Annulus Fibrosus organization and loss of cartilage endplate tissue. The bony endplate displayed sclerotic changes. CONCLUSION: Discectomies lead to terminal degenerative changes. Therefore, these procedures should be indicated with caution specifically when performed for prophylactic purposes.

Cardiovascular effects and intraoperative pharmacokinetics of tramadol in sheep undergoing spinal surgery.

OBJECTIVE: To evaluate the pharmacokinetics of two doses of tramadol during isoflurane anaesthesia in sheep and their ability to prevent the cardiovascular response induced by surgical stimulation. STUDY DESIGN: Prospective randomized controlled study. ANIMALS: A total of 12 healthy sheep (mean weight, 47.5±7.9 kg) undergoing lumbar transpedicular intervertebral disk nucleotomy. METHODS: Sheep were sedated with medetomidine, anaesthesia was induced with propofol and maintained with isoflurane at 1.5 vol.%. Baseline heart rate and blood pressure were measured and sheep were randomly assigned an intravenous injection of tramadol (4 or 6 mg kg-1). Fentanyl was injected as rescue analgesic if cardiovascular parameters were increased more than 20% compared to baseline. If those variables were below 20% of baseline, the concentration of isoflurane was gradually decreased until parameters returned to the original value. Blood collections were performed at pre-assigned times, and concentrations of tramadol and O-desmethyltramadol (M1) assessed by high-performance liquid chromatography. RESULTS: Time from premedication to anaesthesia induction, anaesthesia time, propofol dose and intraoperative body temperature were similar between doses. Cardiovascular variables remained between ±20% of baseline value, and no statistical difference was observed between treatments. Regardless of the dose of tramadol administered, arterial blood pressure was statistically higher than baseline 10 minutes after tramadol administration, but it gradually returned to previous values. A two-compartment model and a non-compartment model described the pharmacokinetics of tramadol and M1, respectively. Plasma concentrations of tramadol rapidly decreased in the first 2 hours for both doses with an elimination half-life of more than 40 minutes. The M1 maximum concentration was similar for both doses, and it was detected in plasma after 35 minutes. CONCLUSIONS AND CLINICAL RELEVANCE: Both doses of tramadol provided adequate cardiovascular stability during spinal surgery in sheep. The pharmacokinetic variables may be used to plan the dosage regime during general anaesthesia.

Effect of a titanium cage as a stand-alone device on biomechanical stability in the lumbosacral spine of canine cadavers.

Degenerative lumbosacral stenosis is a common disease in dogs characterised by intervertebral disc herniation, loss of disc height and stenosis. Decompressive dorsal laminectomy and partial discectomy can cause spinal instability and worsen foraminal stenosis. Pedicle screw and rod fixation (PSRF) with an intervertebral body cage allows for distraction and restoration of disc height and restores foraminal apertures. The aim of this study was to evaluate the ex vivo biomechanical properties of a titanium intervertebral cage alone and in combination with PSRF in the lumbosacral spine of dogs. The range of motion, neutral zone, neutral zone stiffness and elastic zone stiffness of the lumbosacral joint (L7-S1) of nine canine cadavers were determined in flexion/extension, lateral bending and axial rotation for four conditions: (1) native (unmodified) spine; (2) dorsal laminectomy and discectomy; (3) stand-alone cage; and (4) cage in combination with PSRF. The intervertebral disc height decreased after dorsal laminectomy, but increased after insertion of the cage. Insertion of the stand-alone cage decreased the range of motion and neutral zone compared to the laminectomy-discectomy and increased neutral zone stiffness in all directions. The range of motion further decreased after PSRF. From a biomechanical point of view, the use of a stand-alone intervertebral cage is a potential alternative to dorsal fixation of the lumbosacral junction, since it increases spinal stability and restores disc height.

Effect of dorsal laminectomy and dorsal annulectomy with partial lumbosacral discectomy on the volume of the lateral intervertebral neuroforamina in dogs when the lumbosacral junction is extended.

OBJECTIVE: To determine the effect of dorsal annulectomy and partial discectomy on the volume of the lumbosacral lateral intervertebral neurovascular foramina (intervertebral foramina) in canine cadavers during extension of the lumbosacral junction. STUDY DESIGN: Ex vivo experiment. SAMPLE POPULATION: Lumbosacral specimens from 10 large breed dogs euthanatized for reasons unrelated to lumbosacral disease. METHODS: The lumbosacral specimens were clamped in a wooden jig and scanned using computed tomography (CT) with the lumbosacral junction in a neutral position and loaded in extension using a tensioning device. The 3-dimensional volumes of the lumbosacral intervertebral neurovascular foramina were measured and the extent of any disc degeneration was determined from the CT data. A limited dorsal laminectomy of S1 and a dorsal LS annulectomy and partial discectomy were then performed. The lumbosacral specimens were remounted into the jig and loaded into extension at the same tension and were re-scanned. Measurements of intervertebral foraminal volume were then repeated. RESULTS: The mean volume of the lumbosacral foramina (n = 20) was 381 mm3 in neutral (unloaded) positioning and 137 mm3 when loaded in extension. Following dorsal annulectomy, the mean volume was significantly reduced by a mean of 28% to 98 mm3 (P < .01). The foraminal volume was reduced in 19/20 lumbosacral foramen, with the post-annulectomy volume ranging from 31% to 97% of the pre-annulectomy volume (3%-69% reduction). CONCLUSIONS: This study suggests that a dorsal annulectomy with partial discectomy may induce further dynamic collapse of the lumbosacral articulation in the dog.

Effects of conventional and slanted ventral slot procedures on the biomechanical behavior of the C5-C6 vertebral motion unit in dogs.

OBJECTIVE To compare the effects of conventional and slanted ventral slot procedures on the biomechanical behavior of the C5-C6 vertebral motion unit (VMU) in dogs. SAMPLE 14 vertebral columns (C4 through C7) from canine cadavers. PROCEDURES Specimens were assigned to a conventional or slanted ventral slot group (n = 7/group). For each specimen, the C5-C6 VMU was tested in ventral and dorsal bending and positive and negative axial torsion before and after surgery. Range of motion (ROM), stiffness, and energy absorption were compared between the 2 groups. RESULTS Both procedures significantly increased the ROM and stiffness and significantly decreased the energy absorption of the C5-C6 VMU in ventral and dorsal bending. Both procedures also increased the ROM in positive and negative axial torsion. In negative torsion, total stiffness and stiffness over the maximum ROM tested decreased less for the slanted slot procedure than for the conventional slot procedure. There were no significant differences between procedures for any of the other biomechanical outcomes examined. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the biomechanical response of the C5-C6 VMU to the conventional and slanted ventral slot procedures was not significantly different, especially when considering postsurgical instability induced by both procedures. This was most likely due to disruption of the nucleus pulposus and dorsal annulus fibrosus of the disk with both procedures. On the basis of these findings, neither procedure appeared biomechanically superior. Comparative clinical studies are warranted to further evaluate the 2 procedures.

Practice patterns in the management of acute intervertebral disc herniation in dogs.

OBJECTIVES: Acute intervertebral disc herniation is commonly managed by veterinary neurologists and surgeons. Anecdote suggests that patterns of management vary considerably and there is controversy surrounding many aspects of treatment. The goal of this study was to document patterns in management of acute spinal cord injury caused by acute intervertebral disc herniation among these two groups to aid in future discussions on best practices. METHODS: A survey querying diagnostic, medical and surgical practices for dogs with acute intervertebral disc herniation was distributed to diplomates on the databases of the American College of Veterinary Surgeons and the American College of Veterinary Internal Medicine (Neurology). RESULTS: Responses were received from 314 board-certified veterinary surgeons and neurologists. Both groups handled timing of decompression, surgical approach, and most postoperative recommendations in a similar fashion. Case volume differed between groups, with 77% of neurologists and 18% of surgeons managing ê50 cases of acute intervertebral disc herniation per year. MRI was used most frequently as a diagnostic tool by neurologists (75%), while CT was used most commonly by surgeons (58%). Corticosteroids were routinely administered as a neuroprotective strategy by 34% of surgeons and 11% of neurologists. Disc fenestration was performed "always" or "most of the time" by 69% of neurologists and 36% of surgeons. CLINICAL IMPORTANCE: Understanding the common practices in the management of canine acute intervertebral disc herniation can provide a springboard for future discussions regarding the best practices in diagnosing and treating this disease.

Autologous bone marrow mononuclear cell transplant and surgical decompression in a dog with chronic spinal cord injury.

OBJECTIVES: In dogs with deep analgesia caused by acute spinal cord injury from thoracolumbar disk herniation, autologous bone marrow mononuclear cell transplant may improve recovery. The purpose of the present study was to evaluate autologous bone marrow mononuclear cell transplant in a dog that had paraplegia and deep analgesia caused by chronic spinal cord injury. MATERIALS AND METHODS: Autologous bone marrow mononuclear cell transplant was performed in a dog having paraplegia and analgesia for 3 years that was caused by a chronic spinal cord injury secondary to Hansen type I thoracolumbar disk herniation. Functional recovery was evaluated with electrophysiologic studies and the Texas Spinal Cord Injury Scale. RESULTS: Somatosensory evoked potentials were absent before transplant but were detected after transplant. Functional improvement was noted (Texas Spinal Cord Injury Scale: before transplant, 0; after transplant, 6). No adverse events were observed. CONCLUSIONS: Autologous bone marrow mononuclear cell transplant into the subarachnoid space may be a safe and beneficial treatment for chronic spinal cord injury in dogs.

Transarticular fixation with cortical screws combined with dorsal laminectomy and partial discectomy as surgical treatment of degenerative lumbosacral stenosis in 17 dogs: clinical and computed tomography follow-up.

OBJECTIVE: To describe clinical outcome and technical outcome assessed using computed tomography (CT) in dogs with degenerative lumbosacral stenosis (DLSS) treated by dorsal laminectomy, partial discectomy, and transarticular screw fixation. STUDY DESIGN: Retrospective observational case series. ANIMALS: Dogs with DLSS (n = 17). METHODS: Dogs with neurologic and magnetic resonance imaging (MRI) findings compatible with DLSS treated by dorsal laminectomy, partial discectomy and transarticular screw fixation were enrolled. Pre- and postoperative neurologic status was compared. Lumbosacral (LS) angle in extension and misalignment in preoperative MRI were compared with the postoperative CT. Residual mobility of the LS joint after fixation was also evaluated. Status of screws, presence of new bone formation over screw heads/articular facets and presence of adjacent segment disease (ASD) were assessed. RESULTS: Median CT follow-up was 12 months. Clinical improvement was seen in 13 dogs, 2 dogs had intermittent LS pain, and 2 dogs needed revision surgery. In 5 dogs, screws were either pulled out or broken. Reduction of LS angle in extension and misalignment was achieved. Residual mobility of the LS segment was present and ASD was not recognized. CONCLUSIONS: Transarticular screw fixation in dogs with DLSS is associated with a considerable number of technical failures and does not result in rigid stabilization; however, this did not significantly adversely influence clinical outcome.

In vitro biomechanical comparison of the flexion/extension mobility of the canine lumbosacral junction before and after dorsal laminectomy and partial discectomy.

The purpose of this canine cadaver study was to evaluate the range of flexion and extension of the canine lumbosacral spine before and after dorsal laminectomy and partial discectomy. Using a cantilever biomechanical system, a 3Nm bending moment was applied to flex and extend the lumbosacral segment. Motion in L7 (total range of motion [ROM] and neutral zone motion [NZ]) was recorded via a rotational potentiometer. There was a significant increase in NZ and ROM after the decompressive procedures (NZ before decompression 6.0±1.2°; NZ after decompression 7.6±2.1°; ROM before decompression 32.8±6.4°; ROM after decompression 40.2±5.6°). It is unknown whether dorsal laminectomy and partial discectomy will induce the same increased motion in clinical cases. Dogs with lumbosacral subluxation, active dogs with little radiographic degenerative changes and working dogs could benefit from lumbosacral stabilization. This cadaver study demonstrated that dorsal laminectomy and partial discectomy at the lumbosacral junction does lead to significant spinal instability.

Pedicle screw-rod fixation of the canine lumbosacral junction.

OBJECTIVE: To assess pedicle screw-rod fixation (PSRF) of the canine lumbosacral junction (LSJ) ex vivo and in vivo. STUDY DESIGN: Ex vivo cadaver study and in vivo pilot study. SAMPLE POPULATION: Six canine cadaveric lumbosacral spinal specimens and 3 Greyhound dogs diagnosed with degenerative lumbosacral stenosis (DLSS). METHODS: Ex vivo study: PSRF of the LSJ was performed in 6 spinal specimens using guidelines and was evaluated by radiography, computed tomography, and magnetic resonance imaging. In vivo study: 3 Greyhounds diagnosed with DLSS had dorsal laminectomy and partial discectomy combined with PSRF of the LSJ. Curettage of the endplates with insertion of an autologous cancellous bone graft was performed to promote spinal fusion. During 18-month follow-up, dogs were monitored by clinical evaluation, diagnostic imaging, and force plate analysis. Dogs were euthanatized for reasons unrelated to PSRF or their lumbosacral disease, and postmortem imaging and histopathologic investigations of the LSJ were performed. RESULTS: Ex vivo study: Sixteen of 24 inserted screws had an acceptable placement. In vivo study: Ten of 12 inserted screws had acceptable placement. Clinical signs of ``lower'' back pain resolved at 4 weeks after surgery. Diagnostic imaging and histopathology showed no bony spinal fusion of the LSJ. Force plate analysis revealed a trend toward improved pelvic limb function relative to preoperative function. CONCLUSIONS: PSRF of the LSJ of large breed dogs is technically possible. Improvements to the surgical technique to induce spinal fusion and assessment in a larger sample size are required before it can be recommended.

Surgical treatment of disk-associated wobbler syndrome by a distractable vertebral titanium cage in seven dogs.

OBJECTIVE: To evaluate a distractable titanium cage for the treatment of disk-associated wobbler syndrome (DAWS). STUDY DESIGN: Prospective study. ANIMALS: Dogs (n = 7) with DAWS. METHODS: After total discectomy of C5-C6 and C6-C7, the median part of the vertebral body of C6 was removed with preservation of the lateral walls and dorsal cortex. The removed cancellous bone was collected. The implant was placed in the bony defect of C6. After placement, the titanium cage was distracted and affixed by 4 screws. Finally, the implant was filled and covered with cancellous bone. Dogs had follow-up examinations at 1, 3, 6, 12, and 24 months. Six months after surgery, cervical radiographs and computed tomography (CT) were performed. RESULTS: Although no intraoperative complications occurred, correct placement of the cage was technically challenging. Revision surgery was necessary in 2 dogs because of implant loosening and aggravation of vertebral tilting. All dogs improved after discharge from the hospital. In 1 dog, recurrence of clinical signs caused by articular facet proliferation at an adjacent intervertebral disk space occurred. Radiographs at 6 months demonstrated cage subsidence in 4 dogs. In all dogs, CT was suggestive for fusion of the bone graft with the vertebral body. CONCLUSIONS: Although results are promising, technical adaptations will be necessary to make this specific surgical technique, designed for humans, suitable for routine use in dogs.

Postoperative susceptibility artifact during magnetic resonance imaging of the vertebral column in two dogs and a cat.

In humans that have undergone cervical diskectomy, magnetic susceptibility artifacts are often found on postoperative magnetic resonance (MR) images of the affected region. In some patients, these artifacts complicate image interpretation, while in others the artifacts lead to a false diagnosis of spinal cord compression. We describe two dogs and one cat that had susceptibility artifacts visible in postoperative MR images. In each patient, multiple, small-to-large, distinct, magnetic susceptibility artifacts were visible along the surgery site. In both dogs, interpretation was impossible and subsequently computed tomography (CT) was performed. During CT, no cause for the MR artifact was identified. The most likely source of the artifact is microscopic metal fragments from the burr, suction tip or other surgical instruments, but other possible causes include hemorrhage or paramagnetic suture material. These artifacts may cause difficulty in interpretation or suggest a clinical problem. MR imaging therefore might not be the most appropriate examination for patients following certain types of surgery due to the possibility of susceptibility artifacts. Although this artifact probably is common in the postoperative patient, the frequency that this finding will prevent accurate diagnosis is unknown.

Biomechanical flexion-extension forces in normal canine lumbosacral cadaver specimens before and after dorsal laminectomy-discectomy and pedicle screw-rod fixation.

OBJECTIVE: To determine biomechanical flexion-extension forces in cadaveric canine lumbosacral specimens, before and after dorsal laminectomy with partial discectomy, and after dorsal pedicle screw-rod fixation of L7 and S1. STUDY DESIGN: Biomechanical cadaver study. ANIMALS: Cadaveric spine specimens without lumbosacral pathology from mature, intact Labrador retrievers (n=12). METHODS: Lumbosacral spine segments were subjected to a constant bending moment from L6 to S1 in a hydraulic 4-point bending materials testing machine. Force and displacement were recorded during each loading cycle constituting 1 complete flexion-extension cycle of the spine. Each spine segment had 3 series of recordings of 5 loading cycles each: (1) intact spine, (2) after surgical destabilization by dorsal laminectomy and partial discectomy, and (3) after surgical stabilization using dorsal pedicle screw-rod fixation. RESULTS: After dorsal laminectomy and partial discectomy, the neutral zone and range of motion were not different from those in the native spine specimen. After pedicle screw-rod fixation, the neutral zone and range of motion of the instrumented specimen significantly (P<.0001) decreased compared with the native specimen and the specimen after dorsal laminectomy. CONCLUSION: Dorsal laminectomy and partial discectomy does not lead to significant spinal instability in flexion and extension whereas pedicle screw and rod fixation effectively stabilizes the lumbosacral spine. CLINICAL RELEVANCE: Dorsal laminectomy and partial discectomy does not lead to significant spinal instability. Pedicle screw-rod fixation of L7 and S1 may be used to stabilize an unstable L7-S1 junction in dogs with degenerative lumbosacral stenosis.

Magnetic resonance imaging of traumatic intervertebral disc extrusion in dogs.

This retrospective study evaluated the magnetic resonance (mr) images of traumatic disc extrusions in 11 dogs. The findings included a reduction in the volume and signal intensity of the nucleus pulposus, focal hyperintensity within the overlying spinal cord on T (2)-weighted mr images, and subtle spinal cord compression, extraneous material or signal change within the vertebral canal. The largest area of hyperintensity in the spinal cord was directly over or close to the affected disc space, appeared asymmetrical and in the majority of cases was less than one vertebra in length. Parenchymal spinal cord haemorrhage was identified in four of the dogs. Vacuum phenomena, evident as a signal void in the centre of the disc, were identified in two of the dogs. The mr images were distinct from those reported for other causes of spinal cord dysfunction.

Effect of width of disk fenestration and a ventral slot on biomechanics of the canine C5-C6 vertebral motion unit.

OBJECTIVE: To investigate the effects of disk fenestration and ventral slot formation on vertebral motion unit (VMU) range of motion (ROM) and determine the effects of fenestration and ventral slot width on VMU ROM. SAMPLE POPULATION: C5-C6 VMUs from 10 skeletally mature canine cadavers. PROCEDURES: Specimens were assigned to 2 groups (5 specimens/group). Surgery was performed in which width of a fenestration and a ventral slot was 33% (group 1) or 50% (group 2) the width of the vertebral body. Flexion-extension, lateral bending, and axial torsion ROMs were measured during loading before surgery, after fenestration, and after ventral slot formation. Range of motion was compared within groups to determine effects of surgical procedure on stability and between groups to determine effects of width of fenestration and ventral slot on stability. RESULTS: For both groups, fenestration resulted in a significant increase in ROM during flexion-extension, compared with results for intact specimens. Ventral slot formation resulted in a significant increase in ROM during flexion-extension and lateral bending, compared with results for intact specimens. Ventral slot formation resulted in a significant increase in ROM only during flexion-extension, compared with results for fenestrated specimens. There were no significant differences in ROM of the intact, fenestrated, and ventral slot specimens between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Analysis of these results suggests that fenestration and ventral slot procedures each affect the biomechanics of the C5-C6 VMU. Width of a fenestration or ventral slot up to 50% of the width of C5-C6 may be clinically acceptable.