Epidemiological and Clinical Studies in Cats with Thoracolumbar Vertebral Fracture and Luxation and Its Management

2020 ◽  
Author(s):  
I. Nath ◽  
S. Dhanalakshmi ◽  
M. R. Das ◽  
S. K. Panda ◽  
A. K. Kundu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Vertebral Fracture ◽  
Conservative Treatment ◽  
Clinical Outcome ◽  
Epidemiological Data ◽  
Neurological Dysfunction ◽  
Grade 3 ◽  
Time Of Presentation ◽  
Thoracolumbar Vertebral Fracture

Background: Thoraco-lumbar spinal trauma frequently results in neurological dysfunction of varying degrees in domestic cats. The consequences may be permanent disability or death depending on severity and segment of spinal cord affected. Assessment of primary damage to spinal cord is important to prevent secondary damage and complications arising from neurological deficit. Since assessment of neurological dysfunction and its treatment in spinal trauma in cats is an evolving field, the present study was undertaken with an objective to record and associate epidemiological data and clinical examination findings at the time of presentation with clinical outcome on 60th post-treatment day in cats with thoracolumbar vertebral fracture and luxation, for a better clinical approach in this condition. Methods: 24 affected cats were assessed epidemiologically and clinically at the time of presentation. All the cats were treated either conservatively or surgically based on extent of neurological dysfunction and severity of injury on radiographic evaluation. Post-treatment observations was then correlated with epidemiological data and clinical findings to assess the clinical outcome. Result: In the present study, sub-adult semi-domicile cats were most affected and major cause was automobile accident. Presence of concomitant injuries (30%) affected recovery. Thoracolumbar spinal cord segment (T3-L3) was most affected (71%). Among 16 cats with unstable vertebral fractures, 5/6 cats recovered after surgical treatment and 2/10 cats recovered after conservative treatment. Survival and recovery was poor when degree vertebral canal displacement was more than 70% (10 cats). All 7 cats with grade 1 or grade 2 and one cat with grade 3 neurological dysfunction recovered after conservative treatment. 5 cats with grade 3 and 2 cats with grade 4 neurological dysfunction recovered after surgical treatment. Selection of surgical treatment provided better recovery in cats with unstable vertebral fractures and greater degree of neurological dysfunction.

scholarly journals Steinmann Pins and Polymethylmethacrylate Repair of Fourth Lumbar Vertebral Fracture and Dorsocranial Luxation in PuppySteinmann Pins and Polymethylmethacrylate Repair of Fourth Lumbar Vertebral Fracture and Dorsocranial Luxation in Puppy

2020 ◽  
Vol 48 ◽  
Author(s):  
Fernando Bezerra Da Silva Sobrinho ◽  
Ivan Felismino Charas Dos Santos ◽  
Claudia Valéria Seullner Brandão ◽  
Sheila Canevese Rahal ◽  
César Passareli Cândido Lobo ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Vertebral Fracture ◽  
Lumbar Vertebrae ◽  
Lumbar Vertebra ◽  
The Body ◽  
Labrador Retriever ◽  
Lumbar Vertebral Fracture ◽  
Cord Injury ◽  
Fourth Lumbar Vertebra

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. Two 2.0 mm Steinmann pins were placed at 60° angle of the bodies of the second and fifth lumbar vertebrae, and third and fourth lumbar vertebrae. This procedure was repeated on the other side of the vertebral bodies. Sixty grams of polymethylmethacrylate bone cement was applied and the fixation was checked for stability. Muscular, subcutaneous tissue and skin was closed routinely. The dog was paraplegic without any pain and used a wheelchair to assist in locomotion, although it still had urinary and faecal incontinence; no tail control; and the implants were not removed.Discussion: Lumbar vertebral injuries, as in the present case frequently, occur secondary to severe trauma (e.g. hit by car) and seem to have a characteristic fracture pattern. The patient became paraplegic due to spinal cord injury and failure of sensitivity and elimination of urine and feces which can be associated with progressive destruction of neuronal tissue due to secondary vascular and inflammatory events. The radiographic exam was used to confirm the spinal injury and determine whether by conservative or surgical treatment. The treatment choice is related to the number of fractured compartments, and the presence or not of compression. Fractures in two or more compartments are indicative of surgical treatment, similar as the present case. Use of Steinmann pins was to make a rigid fixing system compared with block plates used for the same function. Use of polymethylmethacrylate may also become a complication due to the infection, for this reason was prescribed an antibiotic for 15 days. This procedure proved to be effective since the dog showed no signs of infection. According to the characteristics of the present case report, the use of Steinmann pins and polymethylmethacrylate for repair of transversal fracture through the body of the fourth lumbar vertebra, with dorsocranial displacement of the caudal fragment provided an effective and practical means of stabilisation, promoting decompression, and thus, improving the patient's quality of life.

scholarly journals Spinal Cord Hemangioblastoma : Diagnosis and Clinical Outcome after Surgical Treatment

2007 ◽  
Vol 42 (6) ◽  
pp. 436 ◽  
Author(s):  
Joon Ho Na ◽  
Hyeong Soo Kim ◽  
Whan Eoh ◽  
Jong Hyun Kim ◽  
Jong Soo Kim ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Clinical Outcome

Treatment of spontaneous anterior interosseous nerve palsy

2020 ◽  
Vol 132 (4) ◽  
pp. 1243-1248
Author(s):  
Narihito Kodama ◽  
Kosei Ando ◽  
Yoshinori Takemura ◽  
Shinji Imai
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Symptom Onset ◽  
Nerve Palsy ◽  
Manual Muscle Test ◽  
Anterior Interosseous Nerve ◽  
The Mean ◽  
Initial Recovery ◽  
Grade 3

OBJECTIVEThe purpose of this study was to clarify the clinical outcomes of spontaneous anterior interosseous nerve palsy (AINP) treated nonsurgically or surgically.METHODSThe authors retrospectively evaluated the clinical course of 27 patients affected with AINP, treated nonsurgically or surgically. Thirteen patients underwent surgical treatment (interfascicular neurolysis), and 14 patients underwent conservative nonsurgical treatment. The mean patient age at the onset of symptoms was 49 years (range 17–77 years). The mean follow-up duration from onset to the latest follow-up examination was 23 months (range 12–38 months).RESULTSIn 12 of 14 patients receiving conservative treatment, signs of recovery from the palsy were obtained within 6 months. These patients showed a recovery of manual muscle test (MMT) grade ≥ 3. In contrast, 2 patients who took more than 12 months from symptom onset to initial recovery showed poor recovery (MMT grade ≤ 2). Surgical treatment was performed in 13 patients because of no sign of recovery from palsy. The mean period from symptom onset to the operation was 8.4 months (range 6–14 months). Ten of 13 patients who underwent surgical treatment within 8 months after symptom onset showed good recovery, with MMT grade ≥ 4. However, 3 patients who underwent surgical treatment more than 12 months after onset showed recovery with MMT grade ≤ 3.CONCLUSIONSConservative treatment for AINP may be continued when patients show signs of recovery within 6 months after symptom onset. In contrast, surgical treatment may be performed within 8 months from the onset of symptoms when the patients show no recovery signs for 6 months.

scholarly journals Does surgical treatment increase the progression of spinal cord injury in patients with ossification of posterior longitudinal ligament of cervical spine? A systematic review and meta-analysis

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098178
Author(s):  
Bi Zhang ◽  
Yufei Zhang ◽  
Bin Ma ◽  
Junchi Ma ◽  
Xiaoyong Chen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Posterior Longitudinal Ligament ◽  
Conservative Group ◽  
Cord Injury ◽  
Surgical Group

Purpose: The purpose of this study is to explore if the surgical treatment will accelerate the progression of spinal cord injury (SCI) in patients with cervical Ossification of the posterior longitudinal ligament (OPLL) and if surgery will have better curative effect than conservative treatment. Methods: An extensive search of literature was implemented in PubMed, EMBASE, and other online databases. The quality of the included articles was evaluated according to the Newcastle-Ottawa Quality Assessment Scale, as recommended by the Cochrane manual, and meta-analysis was performed using the review manage5.3 software. Results: No obvious statistical difference was observed in the rate of SCI progression (P > 0.05, OR 1.15 [0.66, 2.00]), cervical range of motion, (P > 0.05, weighted mean difference (WMD) 4.52 [−5.75, 14.79]), and Japanese Orthopedic Association scores before surgery (P > 0.05, WMD −2.78 [−7.87, 2.32]) between the surgical group and conservative treatment group. However the surgical group illustrated obviously higher neurofunctional recovery rate (P < 0.05, OR 6.07 [1.55, 23.78]) and postoperative JOA score of the surgery group (P < 0.05, WMD −0.77 [−1.21, −0.33]) than conservative group. Conclusions: Based on this meta-analysis, there is not enough evidence to indicate that surgery will accelerate the progress of SCI with OPLL. However, the superiority of surgical efficacy can be observed over conservative treatment in terms of relieving neurological symptoms.

Surgical repair of thoraco-lumbar vertebral fracture-luxations in eight cats using screws and polymethylmethacrylate fixation

2014 ◽  
Vol 27 (04) ◽  
pp. 306-312 ◽  
Author(s):  
M. Manassero ◽  
D. Leperlier ◽  
S. Scotti ◽  
V. Viateau ◽  
P. Moissonnier ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Vertebral Fracture ◽  
Clinical Outcome ◽  
Short Term ◽  
Lumbar Vertebral Fracture ◽  
Retrospective Clinical Study ◽  
Spinal Segments

SummaryObjective: To report our clinical experience in the surgical treatment of feline thora-columbar vertebral fracture-luxations using optimal safe implantation corridors as previously described in vitro.Study design: Retrospective clinical study.Materials and Methods: Medical records and radiographs of cats with vertebral fracture- luxations stabilized by screws and polymethylmethacrylate (PMMA) using optimal safe implantation corridors between 2009 and 2011 were reviewed. For each patient the data included: signalment, cause of vertebral fracture-luxations, presence of concurrent injuries, pre- and postoperative neurological grade, surgical treatment, imaging findings, and clinical outcome with short-term (2 weeks) and long-term (12 months) follow-up.Results: Eight cats with vertebral fracture-luxations involving the lumbar (L)(n = 5), the thoracic (T) spinal segments (n = 2), or the thoraco-lumbar junction (n = 1) were included in the study. Screws and PMMA were used bilaterally in five cats and unilaterally in three cats. No surgical intra-operative complications using the defined corridors were recorded. Implant failure followed by spontaneous recovery was recorded in one case. Two cats died in the postoperative period (≤4 days). The short-term and long-term clinical outcome was excellent in four out of eight cats and satisfactory in two out of eight cats.Conclusion and Clinical relevance: This pilot study demonstrates the clinical applicability of optimal safe implantation corridors for stabilization of feline thoraco-lumbar vertebral fracture-luxations with screws and PMMA. This technique can be used with limited risks of iatrogenic injuries for stabilization of vertebral fracture-luxation localized between T11-L4.

scholarly journals Conservative treatment of cervical intervertebral disc disease in a dog with the use of a cervical collar: case report

2020 ◽  
Vol 13 (3) ◽  
pp. 57
Author(s):  
G. F. Pessine ◽  
D. Farias Junior
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Intervertebral Disc ◽  
Conservative Management ◽  
Clinical Signs ◽  
Clinical State ◽  
Intervertebral Disc Disease ◽  
Disc Disease

Intervertebral Disc Disease (IVDD) is the main  spinal cord disease in dogs, especially  of chondrodisthrophic breeds, and it’s  characterized  by structural degeneration of discs, following protrusion or extrusion of debris to the medullar canal, compression and variable degrees of pain, paresis and ataxia. Surgical  descompressive intervention   coupled with disc fenestration are the treatment of choice as it promotes faster recovery with higher succes rates, not withou important morbidity and mortality. The conservative management is considered when the pacient has mild clinical signs, doesn’t have severe medullar compression or contusion lesions on imaging tests, as well as when there are restrictions associated with the clinical state of the pacient or the higher costs of surgical treatment.

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