References

Arzi H, Levinkopf M, Caspi I, Arnold PM External fixation of the spine: surgical salvage option for complex spinal infections. Surg Technol Int. 2010; 19:223-228

Bagley RS Spinal fracture or luxation. Vet Clin North Am Small Anim Pract. 2000; 30:(1)133-153 https://doi.org/10.1016/S0195-5616(00)50006-0

Beal MW, Paglia DT, Griffin GM, Hughes D, King LG Ventilatory failure, ventilator management, and outcome in dogs with cervical spinal disorders: 14 cases (1991-1999). J Am Vet Med Assoc. 2001; 218:(10)1598-1602 https://doi.org/10.2460/javma.2001.218.1598

Beever L, Giles K, Meeson R Postoperative complications associated with external skeletal fixators in cats. J. Feline Med Surg. 2017; 19:(7)727-736 https://doi.org/10.1177/1098612X17699466

Blass CE, Seim HB Spinal fixation in dogs using steinmann pins and methylmethacrylate. Vet Surg. 1984; 13:(4)203-210 https://doi.org/10.1111/j.1532-950X.1984.tb00790.x

Brocal J, Del Río FR, Feliu-Pascual AL Diagnosis and management of lumbar Aspergillus spp. discospondylitis using intraoperative cytology and external stabilization in a dog with disseminated infection. Open Vet J. 2019; 9:(3)185-189 https://doi.org/10.4314/ovj.v9i3.1

Bruce CW, Brisson BA, Gyselinck K Spinal fracture and luxation in dogs and cats: a retrospective evaluation of 95 cases. Vet Comp Orthop Traumatol. 2008; 21:(3)280-284 https://doi.org/10.1055/s-0037-1617373

Bubenik L, Hosgood G Urinary tract infection in dogs with thoracolumbar intervertebral disc herniation and urinary bladder dysfunction managed by manual expression, indwelling catheterization or intermittent catheterization. Vet Surg. 2008; 37:(8)791-800 https://doi.org/10.1111/j.1532-950X.2008.00452.x

Bubenik LJ, Hosgood GL, Waldron DR, Snow LA Frequency of urinary tract infection in catheterized dogs and comparison of bacterial culture and susceptibility testing results for catheterized and noncatheterized dogs with urinary tract infections. J Am Vet Med Assoc. 2007; 231:(6)893-899 https://doi.org/10.2460/javma.231.6.893

Cabassu J, Moissonnier P Surgical treatment of a vertebral fracture associated with a haematogenous osteomyelitis in a dog. Vet Comp Orthop Traumatol. 2007; 20:(3)227-230 https://doi.org/10.1160/VCOT-06-11-0089

Castel A, Olby NJ, Mariani CL, Muñana KR, Early PJ Clinical characteristics of dogs with progressive myelomalacia following acute intervertebral disc extrusion. J Vet Intern Med. 2017; 31:(6)1782-1789 https://doi.org/10.1111/jvim.14829

Cook L, Byron J, Moore S Urological sequelae to acute spinal cord injury in pet dogs: a natural disease model of neuropathic bladder dysfunction. Top Spinal Cord Inj Rehabil. 2019; 25:(3)205-213 https://doi.org/10.1310/sci2503-205

Dewey CW, Marino DJ, Loughin CA Craniocervical junction abnormalities in dogs. N Z Vet J. 2013; 61:(4)202-211 https://doi.org/10.1080/00480169.2013.773851

DiFazio J, Fletcher DJ Updates in the management of the small animal patient with neurologic trauma. Vet Clin North Am Small Anim Pract. 2013; 43:(4)915-940 https://doi.org/10.1016/j.cvsm.2013.03.002

Egger EL Complications of external fixation: a problem-oriented approach. Vet Clin North Am Small Anim Pract. 1991; 21:(4)705-733 https://doi.org/10.1016/S0195-5616(91)50080-2

Fehlings MG, Wilson JR, Tetreault LA A clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the use of methylprednisolone sodium succinate. Glob Spine J. 2017; 7:(3_Suppl)203S-211S https://doi.org/10.1177/2192568217703085

Furlan JC, Noonan V, Cadotte DW, Fehlings MG Timing of decompressive surgery of spinal cord after traumatic spinal cord injury: an evidence-based examination of pre-clinical and clinical studies. J Neurotrauma. 2011; 28:(8)1371-1399 https://doi.org/10.1089/neu.2009.1147

Gallastegui A, Davies E, Zwingenberger AL MRI has limited agreement with CT in the evaluation of vertebral fractures of the canine trauma patient. Vet Radiol Ultrasound. 2019; 60:(5)533-542 https://doi.org/10.1111/vru.12785

Garcia JN, Milthorpe BK, Russell D, Johnson KA Biomechanical study of canine spinal fracture fixation using pins or bone screws with polymethylmethacrylate. Vet Surg. 1994; 23:(5)322-329 https://doi.org/10.1111/j.1532-950X.1994.tb00491.x

Grasmueck S, Steffen F Survival rates and outcomes in cats with thoracic and lumbar spinal cord injuries due to external trauma. J Small Anim Pract. 2004; 45:(6)284-288 https://doi.org/10.1111/j.1748-5827.2004.tb00236.x

Hawthorne J, Blevins W, Wallace L, Glickman N, Waters D Cervical vertebral fractures in 56 dogs: a retrospective study. J Am Anim Hosp Assoc. 1999; 35:(2)135-146 https://doi.org/10.5326/15473317-35-2-135

Hettlich BF, Fosgate GT, Levine JM Accuracy of conventional radiography and computed tomography in predicting implant position in relation to the vertebral canal in dogs. Vet Surg. 2010; 39:(6)680-687 https://doi.org/10.1111/j.1532-950X.2010.00697.x

Jaumard NV, Welch WC, Winkelstein BA Spinal facet joint biomechanics and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng. 2011; 133:(7) https://doi.org/10.1115/1.4004493

Jeffery ND Vertebral fracture and luxation in small animals. Vet Clin North Am Small Anim Pract. 2010; 40:(5)809-828 https://doi.org/10.1016/j.cvsm.2010.05.004

Krauss MW, Theyse LFH, Tryfonidou MA, Hazewinkel HAW, Meij BP Treatment of spinal fractures using Lubra plates. A retrospective clinical and radiological evaluation of 15 cases. 2012; 25:(04)326-331 https://doi.org/10.3415/VCOT-11-07-0096

Kube SA, Olby NJ Managing acute spinal cord injuries. Compend Contin Educ Vet. 2008; 30:(9)496-504

Lanz OI, Jones Jeryl C, Robert B Use of an external fixator to correct spinal fracture/luxation and instability in three dogs. Vet Neurol Neurosurg. 2003 McKee WM. Spinal trauma in dogs and cats: a review of 51 cases. Vet Rec. 1990; 126:(12)285-289

Nel JJ, Kat C-J, Coetzee GL, Staden PJV Biomechanical comparison between pins and polymethylmethacrylate and the SOP locking plate system to stabilize canine lumbosacral fracture-luxation in flexion and extension. Vet Surg. 2017; 46:(6)789-796 https://doi.org/10.1111/vsu.12673

Olby N Current concepts in the management of acute spinal cord injury. J Vet Intern Med. 1999; 13:(5)399-407 https://doi.org/10.1111/j.1939-1676.1999.tb01453.x

Olby N, Levine J, Harris T Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001). J Am Vet Med Assoc. 2003; 222:(6)762-769 https://doi.org/10.2460/javma.2003.222.762

Olby N The pathogenesis and treatment of acute spinal cord injuries in dogs. Vet Clin North Am Small Anim Pract. 2010; 40:(5)791-807 https://doi.org/10.1016/j.cvsm.2010.05.007

Olby NJ, Muguet-Chanoit AC, Lim JH A placebo-controlled, prospective, randomized clinical trial of polyethylene glycol and methylprednisolone sodium succinate in dogs with intervertebral disk herniation. J Vet Intern Med. 2016; 30:(1)206-214 https://doi.org/10.1111/jvim.13657

Schmidli F, Stein V, Aikawa T Fractures of the second cervical vertebra in 66 dogs and 3 cats: a retrospective study. Vet Comp Orthop Traumatol. 2019; 32:(03)200-206 https://doi.org/10.1055/s-0039-1678542

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:(11)1965-1968

Shaffer WO, Baisden J, Fernand R, Matz P Antibiotic prophylaxis in spine surgery. 2013; 13:(10)1387-92 https://doi.org/10.1016/j.spinee.2013.06.030

Shores A Fractures and luxations of the vertebral column. Vet Clin North Am Small Anim Pract. 1992; 22:(1)171-180 https://doi.org/10.1016/S0195-5616(92)50012-2

Sturges BK, Kapatkin AS, Garcia TC Biomechanical comparison of locking compression plate versus positive profile pins and polymethylmethacrylate for stabilization of the canine lumbar vertebrae. Vet Surg. 2016; 45:(3)309-318 https://doi.org/10.1111/vsu.12459

Voss K, Montavon PM Tension band stabilization of fractures and luxations of the thoracolumbar vertebrae in dogs and cats: 38 cases (1993-2002). J Am Vet Med Assoc. 2004; 225:(1)78-83 https://doi.org/10.2460/javma.2004.225.78

Walker TM, Pierce WA, Welch RD External fixation of the lumbar spine in a canine model. Vet Surg. 2002; 31:(2)181-188 https://doi.org/10.1053/jvet.2002.31045

Walter MC, Smith GK, Newton CD Canine lumbar spinal internal fixation techniques a comparative biomechanical study. Vet Surg. 1986; 15:(2)191-198 https://doi.org/10.1111/j.1532-950X.1986.tb00203.x

Wheeler JL, Lewis DD, Cross AR, Sereda CW Closed fluoroscopic-assisted spinal arch external skeletal fixation for the stabilization of vertebral column injuries in five dogs. Vet Surg. 2007; 36:(5)442-448 https://doi.org/10.1111/j.1532-950X.2007.00290.x

Vertebral fractures and luxations in dogs and cats part 2: treatment and surgery options

02 March 2021
Clinical
9 mins read
02 March 2021
Volume 26 · Issue 3
Figure 1. One-year-old crossbreed, non-ambulatory paraparetic, with decreased anal and tail tone, absent perineal reflex. Laterolateral (a and b) and ventrodorsal (d and c), pre- and postoperative radiographs of the L4 vertebral body fracture with luxation of the L4–L5 articular process joints on both sides, representing disruption of all three vertebral compartments.
Figure 1. One-year-old crossbreed, non-ambulatory paraparetic, with decreased anal and tail tone, absent perineal reflex. Laterolateral (a and b) and ventrodorsal (d and c), pre- and postoperative radiographs of the L4 vertebral body fracture with luxation of the L4–L5 articular process joints on both sides, representing disruption of all three vertebral compartments.

Abstract

Assessing the presence of vertebral column instability is essential in animals with vertebral fractures or luxations. Spinal instability is most commonly assessed using a three-compartment model and unstable vertebral fractures and luxations require surgical stabilisation. In cases of compression of the spinal cord (by haematoma, traumatic intervertebral disc extrusion or bone fragment), decompression surgery is necessary. Prompt surgery prevents additional spinal cord damage, but the overall condition of the patient, including any concurrent injuries, needs to be continually kept in mind. The vertebral column can be stabilised using multiple techniques, such as screws, pins, polymethylmetacrylate and plating techniques, as well as external stabilisation and spinal stapling. Complications of spinal surgeries include haemorrhage, infection, neurological deterioration, particularly in cases of spinal stabilisations, implant loosening and failure.

The main objective when treating vertebral fractures and luxations is to provide an environment in which damaged neural tissues can recover their optimal function (Jeffery, 2010). Pharmacological and non-pharmacological therapies address primary injury in spinal cord damage and minimise the effects of secondary injury. The timing and efficacy of treatment of primary and secondary injury significantly affect the prognosis of a neurotrauma patient (DiFazio and Fletcher, 2013).

The critical factors in determining whether conservative or surgical therapy is the most appropriate hinges on the spinal cord compression and spinal ‘instability’. This is based on a three-compartment model (Figure 12 in Vertebral fractions and luxations part 1: diagnosis and prognosis, 10.12968/coan.2020.0027), whereby if two or more of the compartments (dorsal, middle or ventral) are affected (including ligaments), the column is considered unstable and requires stabilisation (Figure 1) (Jeffery, 2010). The three compartments consist of:

Register now to continue reading

Thank you for visiting UK-VET Companion Animal and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.

Register
Or continue by

Signing in with your registered email address

spinal decompression
vertebral column stabilisation
steroids
stabilisation surgeries