Reduction and Fixation of Cranial Cervical Fracture/Luxations using Screws and Polymethylmethacrylate (PMMA) Cement: A Distraction Technique Applied to the Base of the Skull in Thirteen Dogs

Abstract

This surgical distraction technique was a reliable, relatively simple method to obtain reduction of fracture/luxations of C1-2 to re-align the spinal canal. Mortality in this series appears lower than that previously reported and supports surgical management of these injuries.

SURGICAL CORRECTION OF A CERVICAL SPINAL FRACTURE IN A BENNETT'S WALLABY (MACROPUS RUFOGRISEUS)

“…The latter aspect points out the versatility of this technique in smaller patients and is reported in the dog, where it is utilized frequently. 7 Potential surgical risks included infection, implant failure, and spinal canal penetration by implants, but none were noted in this case. As in the dog, degeneration of the intervertebral disc spaces within the area stabilized (C3-4 and C4-5) was not unexpected due to lack of subsequent motion at these locations, spanned by the implants.…”

“…3,10 The most common surgical stabilization method for cervical fractures or luxations is use of ventrally applied pins or screws and polymethylmethacrylate (PMMA) cement to bridge the affected area. 2,3,7,10 Ventral fixation of a midcervical vertebral fracture in a wallaby has not been previously reported.…”

“…9 Cervical fractures account for 20% of all vertebral column fractures of dogs (Canis lupus familiaris) and cats (Felis catus). 2,3,7,8,10 In the dog, most of these injuries involve either C1 or C2, with the axis most-frequently affected, and the odontoid process or body of C2 most-commonly involved. 2,3,7,8,10 The general indications for surgical intervention in cervical fractures or luxations include severe neurologic signs, a progressive decline in neurologic status, obvious vertebral instability (radiographic or clinical), and the persistence of pain or ataxia.…”

“…2,3,7,8,10 In the dog, most of these injuries involve either C1 or C2, with the axis most-frequently affected, and the odontoid process or body of C2 most-commonly involved. 2,3,7,8,10 The general indications for surgical intervention in cervical fractures or luxations include severe neurologic signs, a progressive decline in neurologic status, obvious vertebral instability (radiographic or clinical), and the persistence of pain or ataxia. 3,10 The most common surgical stabilization method for cervical fractures or luxations is use of ventrally applied pins or screws and polymethylmethacrylate (PMMA) cement to bridge the affected area.…”

Computed tomography, magnetic resonance imaging and a novel surgical approach of atlanto-axial instability with incongruence in dogs

“…In fact, considering literature data regarding the treatment of AA instability in toy breeds, conservative options and several surgical stabilisation techniques are described [1,2,10,12,13,15,19,26]. Standard surgical treatment consists of ventral arthrodesis with cross pinning, transarticular lag screw fixation or vertebral plating [1,12,19,21,24].…”