RSS-Feed abonnieren
DOI: 10.3415/VCOT-15-01-0003
Percutaneous transilial pinning for treatment of seventh lumbar vertebral body fracture
A retrospective analysis of 17 casesPublikationsverlauf
Received:
02. Januar 2015
Accepted:
09. Januar 2015
Publikationsdatum:
19. Dezember 2017 (online)

Summary
Objective: To evaluate outcomes after percutaneous application of transilial pinning in dogs with seventh lumbar vertebral body fracture with concurrent lumbosacral luxation.
Methods: We reviewed the medical records of dogs with seventh lumbar vertebral body fracture stabilized with percutaneous transilial pinning that were treated at our hospital between January 2000 and March 2014. Radiographic measurements were used for comparing craniocaudal and ventrodorsal displacement pre- and postoperatively.
Results: Seventeen dogs met the inclusion criteria. The neurological status of the majority of treated dogs improved quickly, with immediate pain reduction after surgery. Implants were well tolerated throughout the application period and were removed at a mean time of 54.4 ± 9.2 days. One dog experienced a major complication (implant failure) and required surgical revision a week after the initial procedure. Minor complications included pin-tract inflammation, signs of back pain lasting five weeks and acute lameness after implant removal. Postoperative radiographic measurements showed shortening of the vertebral body and residual dorsoventral dislocation. Otherwise, functional recovery was good (5 of 17 dogs) to excellent (10 of 17 dogs) in the majority of the patients.
Clinical relevance: The use of two percutaneous transilial pins can be considered as treatment for the management of seventh lumbar fracture-luxation in dogs. Our modified stabilization technique is relatively easy to perform; less invasive on the soft tissues; and uses implants that are versatile, modifiable, and easily removable.
-
References
- 1 Thacher C. Biomechanics of cranial fractures, spinal fractures, and luxations. In Bojrab MJ. Disease mechanisms in small animal surgery. Philadelphia: Lea & Febiger; 1993. Pg 1006-1007
- 2 Beaver DP, MacPherson GC, Muir P. et al. Methyl-methacrylate and bone screw repair of seventh lumbar vertebral fracture-luxations in dogs. J Small Anim Pract 1996; 37: 381-386.
- 3 Selcer RR, Bubb WJ, Walker TL. Management of vertebral column fractures in dogs and cats: 211 cases (1977-1985). J Am Vet Med Assoc 1991; 198: 1965-1968.
- 4 Harrington ML, Bagley RS. Realignment of a seventh lumbar vertebral fracture/luxation using a Senn retractor in two puppies. J Am Anim Hosp Assoc 1998; 34: 377-380.
- 5 Curtis WD. Surgery of the Cauda Equina. In Fossum TW. editor Small Animal Surgery. St.Louis, Missouri: Elsevier Mosby; 2013. pg 1539-1544
- 6 Slocum B, Rudy RL. Fractures of the seventh lumbar vertebrae in the dog. J Am Anim Hosp Assoc 1975; 11: 167-174.
- 7 Fletcher TF, Kitchell RL. Anatomical studies on the spinal cord segments of the dog. Am J Vet Res 1966; 27: 1759-1767.
- 8 Kinns J, Mai W, Seiler G. et al. Radiographic sensitivity and negative predictive value for acute canine spinal trauma. Vet Radiol Ultrasound 2006; 47: 563-570.
- 9 Slocum B, Slocum TD. Fracture of seventh lumbar vertebra. In Bojrab MJ, Ellison GW, Slocum B. editors Current Techniques in Small Animal Surgery. Philadelphia: Lippincott Williams & Wilkins; 1998. Pg 814-823
- 10 Garcia JN, Milthorpe BK, Russel D. et al. Biomechanical study of canine spinal fracture using pins or bone screws with polimethylmethacrylate. Vet Surg 1994; 23: 322-329.
- 11 Ullmann SL, Boudrieau RJ. Internal skeletal fixation using a kirschner apparatus for stabilization of fracture/luxations of the lumbosaral joint in six dogs. Vet Surg 1993; 22: 11-17.
- 12 Krauss MW, Theyse LFH, Tryfonidou MA. et al. Treatment of spinal fractures using Lubra plates. Vet Comp Orthop Traumatol 2012; 25: 326-331.
- 13 Dulisch ML, Nichols JB. A surgical technique for management of lower lumbar fractures: case report. Vet Surg 1981; 2: 90-93.
- 14 Shores A, Nichols C, Rochat M. et al. Combined Kirschner-Ehmer device and dorsal spinal plate fixation technique for caudal lumbar vertebral fractures in dogs. J Am Vet Med Assoc 1989; 195: 335-339.
- 15 Lewis DD, Stampley A, Bellah R. et al. Repair of sixth lumbar vertebral fracture-luxation, using transilial pins and plastic spinous-process plates in six dogs. J Am Vet Med Assoc 1989; 194: 538-541.
- 16 Evans HE, de Lahunta A. Miller’s Anatomy of the Dog. St.Louis, Missouri: Elsevier; 2013. pg. 121
- 17 Sharp NJH, Wheeler SJ. Small Animal Spinal Disorders. St.Louis, Missouri: Elsevier Mosby; 2005. pg. 32and -296
- 18 Oberli HR, Frigg R, Schenk R. External fixator: surgical technique, pinless fixator, change in procedure. Helv Chir Acta 1994; 60: 1073-1080.
- 19 Bednar DA. Experience with the “fixateur interne”: initial clinical results. J Spinal Disord 1992; 5: 93-96.
- 20 Sim E, Stergar PM. The fixateur interne for stabilising fractures of the thoracolumbar and lumbar spine. Int Orthop 1992; 16: 322-329.
- 21 Sim E. Spinal internal fixator--analysis of problems in 28 cases. Wien Klin Wochenschr 1992; 104: 349-355.
- 22 Phillips L, Blackmore J. Kirschner-Ehmer device alone to stabilize caudal lumbar fractures in small dogs. Vet Comp Orthop Traumatol 1991; 4: 112-115.
- 23 Lanz I O, Jones JC, Bergman R. Use of an external skeletal fixator to correct spinal fracture/luxation and instability in three dogs [Article from eJournal]. Vet Neurol Neurosurg J 2000; 2: 1 [cited on 2015 August 18]. Available at http://www.vin.com/VNNJ/Journal.plx?AID=1471085
- 24 de Lahunta A, Glass E. Veterinary Neuroanatomy and Clinical Neurology. St.Louis, Missouri: Saunders Elsevier; 2009. pg. 84
- 25 Jacobson A, Schrader SC. Peripheral nerve injury associated with fracture or fracture-dislocation of the pelvis in dogs and cats: 34 cases (1978-1982). J Am Vet Med Assoc 1987; 190: 569-572.
- 26 Forterre F, Tomek A, Rytz U. et al. Iatrogenic sciatic nerve injury in eighteen dogs and nine cats (1997-2006). Vet Surg 2007; 36: 464-471.
- 27 Wheeler JL, Lewis DD, Cross AR. et al. Closed fluoroscopic-assisted spinal arch external skeletal fixation for the stabilization of vertebral column injuries in five dogs. Vet Surg 2007; 36: 442-448.
- 28 Bruce CW, Brisson BA, Gyselinck K. Spinal fracture and luxations in dog and cats: a retrospective evaluation of 95 cases. Vet Comp Orthop Traumatol 2008; 21: 280-284.