Vertebral stabilisation for cervical spondylopathy using a screw and washer technique

Abstract

A transvertebral screw and interbody washer technique was used to stabilise the vertebrae and maintain the intervertebral space in 34 adult dobermann pinschers with cervical spondylopathy. The long term success of the procedure was 50 per cent. Pre‐operatively three dogs were considered mildly ataxic, 16 moderately ataxic, 13 severely ataxic and two non‐ambulatory. Thirty dogs had radiographic changes of calcified disc, vertebral malalignment or narrow intervertebral disc space and all dogs had myelographic abnormalities in the caudal cervical spine. Vertebral malalignment and narrow intervertebral space correlated closely with myelographic cord compression. However, compressive lesions were not identified in 11 cases on plain films. Follow‐up was available on 30 dogs of which 25 showed neurological improvement. This was temporary in 10 cases which were destroyed two weeks to three years following surgery.

Cervical spondylomyelopathy

“…The surgeon may also cause iatrogenic spinal cord damage (Read et al, 1983;Lipsitz et al, 2001), vertebral fracture (McKee et al, 1989), induce pneumomediastinum (Marchevsky and Richardson, 1999), perform surgery at the wrong site, or simply fail to understand certain limitations of the technique itself (11.17C). Prolonged or excessive extension of the neck during surgery is undesirable as it causes spinal cord compression (11.10).…”

“…A small fracture is visible at the ventral aspect of C5 (arrow), presumably due to hyperflexion injury (Bruecker et al, 1989b;McKee et al, 1989). B: Distraction-stabilization were performed using screws and bone cement.…”

Cervical spondylomyelopathy in dogs

“…According to Adamo et al (2007), ventral slot combined with an artificial disc prosthesis was better able to mimic the behavior of intact cadaver spines compared to ventral slot alone or the pin-polymethylmethacrylate technique. the initial and permanent distraction of the affected intervertebral disc space without the common complication of vertebral end plate failure-resorption and consequent loss of distraction (McKee et al, 1989;Rusbridge et al, 1998;McKee et al, 1999). The use of polymethylmethacrylate by itself carries a risk for complications, e.g., oesophageal eruption or thermal damage to the spinal cord.…”

Disc extrusion in a Rottweiler dog with caudal cervical spondylomyelopathy after failure of intervertebral distraction/stabilisation

“…1,6 Many different surgical techniques h a ve been used to treat CDDV, i n volving either direct decompre s s i o n alone by fenestration and a ventral slot over the affected IVDD, or decompre ssion by linear traction combined with intervertebral stabilisation. [2][3][4][5]7 Only the latter techniques address the primary pathophysiology of the condition. T h e re p o rted success rates for distraction/ stabilisation pro c e d u res are 70% to 90%.…”

“…T h e re p o rted success rates for distraction/ stabilisation pro c e d u res are 70% to 90%. [2][3][4][5]7 Despite initial success, deterioration may occur weeks to months after n e u rological re c ove ry. Most commonly this is secondary to domino effect wher e a dynamic compre s s i ve lesion deve l o p s at an adjacent IVDS.…”