Short-Term Clinical and Radiographical Outcome after Application of Anchored Intervertebral Spacers in Dogs with Disc-Associated Cervical Spondylomyelopathy
10 February 2018
22 October 2018
08 February 2019 (eFirst)
Objectives The purpose of this study was to assess the short-term outcome of a new intervertebral anchored fusion device (C-LOX) for the treatment of disc associated cervical spondylomyelopathy (DA-CSM) in dogs, based on clinical and radiographical follow-up data.
Materials and Methods To be included in the study, dogs had to be clinically affected by DA-CSM treated with surgical distraction/stabilization using the anchored intervertebral spacer (C-LOX). Neurological signs, as well as diagnostic imaging performed pre-, immediately postoperatively, and after 6 weeks and 3 months were assessed. If available, clinical follow-up after 3 months was documented.
Results Thirty-seven cases were enrolled in the study. Outcome at 3 months was available in 25 dogs; improvement of neurological status was documented in 25/25 cases.
The most common postoperative complication was screw loosening and/or breakage (n = 22), followed by subsidence (n = 15). Four dogs required revision surgery.
Clinical Significance Distraction/stabilization of DA-CSM in dogs with the C-LOX device resulted in short-term clinical improvement in 33/37 treated cases. The high incidence of screw loosening was taken into consideration and modification of the implant with a new locking system and new screw dimensions was required. The C-LOX device seems to be a valuable alternative to more complicated distraction–fusion techniques.
Keywordscervical spondylomyelopathy - neurosurgery - dog - distraction - stabilization - anchored intervertebral spacer
All authors contributed to conception of study, study design, acquisition of data and data analysis and interpretation. All authors also drafted, revised and approved the submitted manuscript.
- 1 De Decker S, da Costa RC, Volk HA, Van Ham LM. Current insights and controversies in the pathogenesis and diagnosis of disc-associated cervical spondylomyelopathy in dogs. Vet Rec 2012; 171 (21) 531-537
- 2 da Costa RC. Cervical spondylomyelopathy (wobbler syndrome) in dogs. Vet Clin North Am Small Anim Pract 2010; 40 (05) 881-913
- 3 McKee WM, Sharp NJ. Cervical Spondylopathy. In: Slatter D. , ed. Textbook of Small Animal Surgery. 2nd ed. London, UK: Saunders; 2003: 1180-1193
- 4 Sharp NJ, Cofone M, Robertson ID. , et al. Computed tomography in the evaluation of caudal cervical spondylomyelopathy of the Doberman Pinscher. Vet Radiol Ultrasound 1995; 36: 100-108
- 5 De Decker S, Caemaert J, Tshamala MC. , et al. Surgical treatment of disk-associated wobbler syndrome by a distractable vertebral titanium cage in seven dogs. Vet Surg 2011; 40 (05) 544-554
- 6 Taylor-Brown FE, Cardy TJ, Liebel FX. , et al. Risk factors for early post-operative neurological deterioration in dogs undergoing a cervical dorsal laminectomy or hemilaminectomy: 100 cases (2002-2014). Vet J 2015; 206 (03) 327-331
- 7 Kelly MP, Eliasberg CD, Riley MS, Ajiboye RM, SooHoo NF. Reoperation and complications after anterior cervical discectomy and fusion and cervical disc arthroplasty: a study of 52,395 cases. Eur Spine J 2018; 27 (06) 1432-1439
- 8 Anderson PA, Sasso RC, Riew KD. Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis. Spine 2008; 33 (12) 1305-1312
- 9 Adamo PF, Kobayashi H, Markel M, Vanderby Jr R. In vitro biomechanical comparison of cervical disk arthroplasty, ventral slot procedure, and smooth pins with polymethylmethacrylate fixation at treated and adjacent canine cervical motion units. Vet Surg 2007; 36 (08) 729-741
- 10 Adamo PF. Cervical arthroplasty in two dogs with disk-associated cervical spondylomyelopathy. J Am Vet Med Assoc 2011; 239 (06) 808-817
- 11 Solano MA, Fitzpatrick N, Bertran J. Cervical distraction-stabilization using an intervertebral spacer screw and string-of pearl (SOP™) plates in 16 dogs with disc-associated Wobbler Syndrome. Vet Surg 2015; 44 (05) 627-641
- 12 Steffen F, Voss K, Morgan JP. Distraction-fusion for caudal cervical spondylomyelopathy using an intervertebral cage and locking plates in 14 dogs. Vet Surg 2011; 40 (06) 743-752
- 13 Voss K, Steffen F, Montavon PM. Use of the ComPact UniLock System for ventral stabilization procedures of the cervical spine: a retrospective study. Vet Comp Orthop Traumatol 2006; 19 (01) 21-28
- 14 Hettlich BF, Allen MJ, Glucksman GS, Fosgate GT, Litsky AS. Effect of an intervertebral disk spacer on stiffness after monocortical screw/polymethylmethacrylate fixation in simulated and cadaveric canine cervical vertebral columns. Vet Surg 2014; 43 (08) 988-994
- 15 Bergman RL, Levine JM, Coates JR, Bahr A, Hettlich BF, Kerwin SC. Cervical spinal locking plate in combination with cortical ring allograft for a one level fusion in dogs with cervical spondylotic myelopathy. Vet Surg 2008; 37 (06) 530-536
- 16 Bruecker KA, Seim III HB, Withrow SJ. Clinical evaluation of three surgical methods for treatment of caudal cervical spondylomyelopathy of dogs. Vet Surg 1989; 18 (03) 197-203
- 17 Ellison GW, Seim III HB, Clemmons RM. Distracted cervical spinal fusion for management of caudal cervical spondylomyelopathy in large-breed dogs. J Am Vet Med Assoc 1988; 193 (04) 447-453
- 18 Spivak JM, Chen D, Kummer FJ. The effect of locking fixation screws on the stability of anterior cervical plating. Spine 1999; 24 (04) 334-338
- 19 Pitzen T, Barbier D, Tintinger F, Steudel WI, Strowitzki M. Screw fixation to the posterior cortical shell does not influence peak torque and pullout in anterior cervical plating. Eur Spine J 2002; 11 (05) 494-499
- 20 Richman JD, Daniel TE, Anderson DD, Miller PL, Douglas RA. Biomechanical evaluation of cervical spine stabilization methods using a porcine model. Spine 1995; 20 (20) 2192-2197
- 21 Trotter EJ. Cervical spine locking plate fixation for treatment of cervical spondylotic myelopathy in large breed dogs. Vet Surg 2009; 38 (06) 705-718
- 22 Schöllhorn B, Bürki A, Stahl C, Howard J, Forterre F. Comparison of the biomechanical properties of a ventral cervical intervertebral anchored fusion device with locking plate fixation applied to cadaveric canine cervical spines. Vet Surg 2013; 42 (07) 825-831
- 23 Rusbridge C, Wheeler SJ, Torrington AM, Pead MJ, Carmichael S. Comparison of two surgical techniques for the management of cervical spondylomyelopathy in dobermanns. J Small Anim Pract 1998; 39 (09) 425-431
- 24 Johnson JA, da Costa RC, Bhattacharya S, Goel V, Allen MJ. Kinematic motion patterns of the cranial and caudal canine cervical spine. Vet Surg 2011; 40 (06) 720-727
- 25 Breit S, Künzel W. Shape and orientation of articular facets of cervical vertebrae (C3-C7) in dogs denoting axial rotational ability: an osteological study. Eur J Morphol 2002; 40 (01) 43-51
- 26 Farfan HF, Cossette JW, Robertson GH, Wells RV, Kraus H. The effects of torsion on the lumbar intervertebral joints: the role of torsion in the production of disc degeneration. J Bone Joint Surg Am 1970; 52 (03) 468-497
- 27 Cook SD, Patron LP, Christakis PM, Bailey KJ, Banta C, Glazer PA. Comparison of methods for determining the presence and extent of anterior lumbar interbody fusion. Spine 2004; 29 (10) 1118-1123
- 28 Farey ID, McAfee PC, Davis RF, Long DM. Pseudarthrosis of the cervical spine after anterior arthrodesis. Treatment by posterior nerve-root decompression, stabilization, and arthrodesis. J Bone Joint Surg Am 1990; 72 (08) 1171-1177
- 29 Jeffery ND, McKee WM. Surgery for disc-associated wobbler syndrome in the dog--an examination of the controversy. J Small Anim Pract 2001; 42 (12) 574-581