Case Report: Spinal Stabilization Surgery Using a Novel Custom-Made Titanium Fixation System for the Spinal Instability Caused by Vertebral Malformation in a Dog

A 2-year-old Maltese was presented with wobbly gait of the pelvic limbs. Based on imaging examinations, a diagnosis of congenital malformation at T5–T8 and severe kyphosis causing spinal cord compression at T6–T7 was made. Dorsal laminectomy and stabilization of T6 and T7 vertebrae were performed. As the size of the vertebrae was small and they were severely deformed, novel custom-made titanium implants were used for spinal stabilization. Clinical signs were resolved 2 weeks after surgery. Although radiographic examination 373 days after surgery showed slight loosening of implants, post-operative course remained uneventful. This report describes the use of novel custom-made titanium implants for spinal fixation surgery in a dog.

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Percutaneous surgery for treatment of epidural spinal cord compression and spinal instability: technical note

Neurosurgical FOCUS ◽

10.3171/2016.8.focus16175 ◽

2016 ◽

Vol 41 (4) ◽

pp. E2 ◽

Cited By ~ 9

Author(s):

Claudio E. Tatsui ◽

Telmo A. B. Belsuzarri ◽

Marilou Oro ◽

Laurence D. Rhines ◽

Jing Li ◽

...

Keyword(s):

Spinal Cord ◽

Hospital Stay ◽

Scale Score ◽

Spinal Cord Compression ◽

Systemic Treatment ◽

Cord Compression ◽

Spinal Instability ◽

Spinal Stabilization ◽

Oncological Treatment ◽

Before And After

OBJECTIVE An emerging paradigm for treating patients with epidural spinal cord compression (ESCC) caused by metastatic tumors is surgical decompression and stabilization, followed by stereotactic radiosurgery. In the setting of rapid progressive disease, interruption or delay in return to systemic treatment can lead to a negative impact in overall survival. To overcome this limitation, the authors introduce the use of spinal laser interstitial thermotherapy (sLITT) in association with percutaneous spinal stabilization to facilitate a rapid return to oncological treatment. METHODS The authors retrospectively reviewed a consecutive series of patients with ESCC and spinal instability who were considered to be poor surgical candidates and instead were treated with sLITT and percutaneous spinal stabilization. Demographic data, Spine Instability Neoplastic Scale score, degree of epidural compression before and after the procedure, length of hospital stay, and time to return to oncological treatment were analyzed. RESULTS Eight patients were treated with thermal ablation and percutaneous spinal stabilization. The primary tumors included melanoma (n = 3), lung (n = 3), thyroid (n = 1), and renal cell carcinoma (n = 1). The median Karnofsky Performance Scale score before and after the procedure was 60, and the median hospital stay was 5 days (range 3–18 days). The median Spine Instability Neoplastic Scale score was 13 (range 12–16). The mean modified postoperative ESCC score (2.75 ± 0.37) was significantly lower than the preoperative score (4.5 ± 0.27) (Mann-Whitney test, p = 0.0044). The median time to return to oncological treatment was 5 days (range 3–10 days). CONCLUSIONS The authors present the first cohort of sLITT associated with a percutaneous spinal stabilization for the treatment of ESCC and spinal instability. This minimally invasive technique can allow a faster recovery without prejudice of adjuvant systemic treatment, with adequate local control and spinal stabilization.

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Current Strategies in the Management of Spinal Metastatic Disease

Swiss Surgery ◽

10.1024/1023-9332.9.2.55 ◽

2003 ◽

Vol 9 (2) ◽

pp. 55-62 ◽

Cited By ~ 7

Author(s):

Bartanusz ◽

Porchet

Keyword(s):

Spinal Cord ◽

Surgical Techniques ◽

Cord Compression ◽

Treatment Modalities ◽

Surgical Approaches ◽

Spinal Stabilization ◽

Management Algorithm ◽

Specific Manner ◽

Extensive Surgery ◽

Selection Of

The treatment of metastatic spinal cord compression is complex. The three treatment modalities that are currently applied (in a histologically non-specific manner) are surgery, radiotherapy and the administration of steroids. The development of new spinal instrumentations and surgical approaches considerably changed the extent of therapeutic options in this field. These new surgical techniques have made it possible to resect these tumours totally, with subsequent vertebral reconstruction and spinal stabilization. In this respect, it is important to clearly identify those patients who can benefit from such an extensive surgery. We present our management algorithm to help select patients for surgery and at the same time identifying those for whom primary non-surgical therapy would be indicated. The retrospective review of surgically treated patients in our department in the last four years reveals a meagre application of conventional guidelines for the selection of the appropriate operative approach in the surgical management of these patients. The reasons for this discrepancy are discussed.

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Epidemiology of spinal cord and column tumors

Neuro-Oncology Practice ◽

10.1093/nop/npaa046 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. i5-i9

Author(s):

Joshua T Wewel ◽

John E O’Toole

Keyword(s):

Spinal Cord ◽

Treatment Options ◽

Survival Rates ◽

Spinal Metastases ◽

Cord Compression ◽

Severe Form ◽

Spinal Instability ◽

Treatment Cascade ◽

Tumor Pathology ◽

Pathologic Fractures

Abstract The spine is a frequent location for metastatic disease. As local control of primary tumor pathology continues to improve, survival rates improve and, by extension, the opportunity for metastasis increases. Breast, lung, and prostate cancer are the leading contributors to spinal metastases. Spinal metastases can manifest as bone pain, pathologic fractures, spinal instability, nerve root compression, and, in its most severe form, spinal cord compression. The global extent of disease, the spinal burden, neurologic status, and life expectancy help to categorize patients as to their candidacy for treatment options. Efficient identification and workup of those with spinal metastases will expedite the treatment cascade and improve quality of life.

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New Percutaneously Inserted Spinal Fixation System

Spine ◽

10.1097/01.brs.0000115143.14254.da ◽

2004 ◽

Vol 29 (6) ◽

pp. 703-709 ◽

Cited By ~ 18

Author(s):

George P. Teitelbaum ◽

Samuel Shaolian ◽

Cameron G. McDougall ◽

Mark C. Preul ◽

Neil R. Crawford ◽

...

Keyword(s):

Spinal Fixation ◽

Fixation System

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Radiation-Sensitive Spine Tumor

Spinal Neurosurgery ◽

10.1093/med/9780190887773.003.0017 ◽

2018 ◽

pp. 159-174

Author(s):

Adam M. Robin ◽

Ilya Laufer

Keyword(s):

Spinal Cord ◽

Multiple Myeloma ◽

Spinal Cord Compression ◽

Cauda Equina ◽

Spinal Metastases ◽

Cord Compression ◽

External Beam Radiation ◽

Spinal Instability ◽

Mechanical Instability

A decision-making framework called NOMS (neurologic, oncologic, mechanical and systemic) facilitates and guides therapeutic decisions for patients with spinal metastases. Patients should be evaluated for signs of myelopathy or cauda equina syndrome. The Epidural Spinal Cord Compression (ESCC) scale facilitates reporting of the degree of radiographic spinal cord compression. A determination of the expected histology-specific tumor response to conventionally fractionated external beam radiation (cEBRT) and systemic therapy should be made. Radiation therapy effectively treats biologic pain for radiosensitive tumors such as multiple myeloma. Patients should undergo a careful evaluation of movement-associated pain as tumor-induced spinal instability is an independent indication for surgery. Determination of tumor-associated mechanical instability can be facilitated by the Spinal Instability Neoplastic Score (SINS). Herein, the authors present a case of spinal multiple myeloma managed using the NOMS framework and in consideration of current evidence and treatment paradigms.

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Traumatic bone cyst of mandible: a case series

Journal of Medical Case Reports ◽

10.1186/s13256-019-2220-7 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Farnoosh Razmara ◽

Zahra Ghoncheh ◽

Ghazal Shabankare

Keyword(s):

Bone Cyst ◽

Clinical Signs ◽

Case Series ◽

Signs And Symptoms ◽

Radiographic Examination ◽

Radiographic Evaluation ◽

History Of ◽

Mandibular Region ◽

Clinical Signs And Symptoms ◽

Anterior Mandible

Abstract Background A traumatic bone cyst is an uncommon nonneoplastic lesion of the jaws that is considered as a “pseudocyst” because of the lack of an epithelial lining. This lesion is particularly asymptomatic and therefore is diagnosed by routine dental radiographic examination as a unilocular radiolucency with scalloped borders, mainly in the posterior mandibular region. The exact etiopathogenesis of the lesion remains uncertain, though it is often associated with trauma. Case presentation We report three Persian cases of traumatic bone cyst with different clinical and radiographic features, and we present a review of the literature to further discuss diagnostic and treatment challenges. Only one of the three patients reported a history of trauma, and despite the usual signs and symptoms of the lesion, extension of the defect to the ramus, swelling of the lingual cortex, and their unusual presence in the anterior mandible were noted in these patients. Conclusions Because features of this cyst can be varied, careful history taking and radiographic evaluation alongside the clinical signs and symptoms have a very significant role in definitive diagnosis, appropriate treatment, and accurate assessment of prognosis.

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Rapid prototyping to design a customized locking plate for pancarpal arthrodesis in a giant breed dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-13-04-0055 ◽

2014 ◽

Vol 27 (01) ◽

pp. 85-89 ◽

Cited By ~ 7

Author(s):

T. Nicetto ◽

M. Petazzoni

Keyword(s):

Rapid Prototyping ◽

Locking Plate ◽

Three Dimensional ◽

Radiographic Examination ◽

Implant Position ◽

Plastic Model ◽

Computed Tomography Images ◽

Custom Made ◽

Osseous Union

SummaryThis report describes the treatment of traumatic carpal hyperextension in a giant breed dog by pancarpal arthrodesis using a custom- made Fixin locking plate, created with the aid of a three-dimensional plastic model of the bones of the antebrachium produced by rapid prototyping technology.A three-year-old 104 kg male Mastiff dog was admitted for treatment of carpal hyperextension injury. After diagnosis of carpal instability, surgery was recommended. Computed tomography images were used to create a life-size three-dimensional plastic model of the forelimb. The model was used as the basis for constructing a customized 12-hole Fixin locking plate. The plate was used to attain successful pancarpal arthrodesis in the animal.Radiographic examination after 74 and 140 days revealed signs of osseous union of the arthrodesis. Further clinical and radiographic follow-up examination three years later did not reveal any changes in implant position or complications.

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Long-term Results of Conservative Treatment, Excision Arthroplasty and Triple Pelvic Osteotomy for the Treatment of Hip Dysplasia in the Immature Dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632578 ◽

1997 ◽

Vol 10 (02) ◽

pp. 101-110 ◽

Cited By ~ 19

Author(s):

J. Dupuis ◽

G. Beauregard ◽

N. H. Bonneau ◽

L. Breton ◽

J. Planté

Keyword(s):

Femoral Head ◽

Conservative Treatment ◽

Head And Neck ◽

Hip Dysplasia ◽

Clinical Signs ◽

Pelvic Osteotomy ◽

Long Term Results ◽

Radiographic Examination ◽

Conservative Group ◽

Excision Arthroplasty

SummaryThe efficiency of conservative treatment, excision arthroplasty of the femoral head and neck and triple pelvic osteotomy for the treatment of hip dysplasia in the immature dog were compared using locomotor, physical and radiographic examinations and owner’s evaluation. Cases selected for this study were dogs diagnosed with bilateral hip dysplasia, initially admitted with clinical signs (lameness, pain), immature at the beginning of the treatment (less than 12 months of age), with both hips subjected to the same treatment (conservative treatment, excision arthroplasty of the femoral head and neck or triple pelvic osteotomy). These dogs never showed any musculoskeletal problems other than hip dysplasia and the surgical treatment had been completed at least 20 months prior to re-evaluation time. Fourteen hips were re-evaluated in the conservative group, 16 in the triple pelvic osteotomy group and ten in the excision arthroplasty group. Locomotor, physical and owner’s evaluations demonstrated the superiority of the triple pelvic osteotomy. These evaluations also showed that excision arthroplasty was more efficient than conservative treatment. Radiographic examination demonstrated the obvious superiority of the triple pelvic osteotomy over conservative treatment.Locomotor, physical and owner’s evaluations demonstrated the superiority of the triple pelvic osteotomy over conservative treatment and excision arthroplasty for the treatment of hip dysplasia in the immature dog. Radiographic examination demonstrated the obvious superiority of the triple pelvic osteotomy over conservative treatment for joint congruence and control of degenerative joint disease.

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