Espadas Irene, Maddox Thomas W, de Vicente Felipe
Small Animal Teaching Hospital, University of Liverpool, UK.
J Feline Med Surg. 2018 Dec;20(12):1149-1157. doi: 10.1177/1098612X18757592. Epub 2018 Feb 19.
The objective of this study was to define safe corridors for the optimal placement of bicortical implants in the feline cervical spine (C2-T1) using CT.
CT images of feline cervical spines (n = 16) were reviewed retrospectively. Multiplanar reconstructions were used to define the optimal safe corridors. Safe corridors were defined by their angle of insertion, width and length. The insertion point within the vertebral body was also described. Vertebral measurements were compared between vertebrae using multilevel linear regression, and left and right measurements within vertebrae were compared with the paired samples Wilcoxon signed-rank test. A P value <0.05 was considered significant for all analyses.
The safe corridor insertion points were located within the caudal third of the vertebral body in C2 (mean cranial vertebral ratio 0.73) and in the cranial third of the vertebral bodies from C3-T1 (mean cranial vertebral ratios 0.34-0.38). Mean safe corridor widths ranged from 1.04 mm in C2 to 2.30 mm in C7 and T1. The mean right and left optimal angles of implantation were, respectively, 21.79° and 21.49° for C2, 45.26° and 46.19° for C3, 51.48° and 51.04° for C4, 53.52° and 54.30° for C5, 56.36° and 56.65° for C6, 63.40° and 64.92° for C7, and 53.90° and 52.90° for T1. There were statistically significant differences between vertebrae in almost every measurement.
Cervical vertebral safe corridors in cats are narrow and differ to those reported in dogs. Safe corridors are located in the caudal third of C2 and cranial third of the C3-T1 vertebral bodies. Current recommendations for implant sizes should be reviewed, as 1.5-2 mm implants would be oversized for bicortical implantation in most of the feline cervical vertebrae.
本研究的目的是利用CT确定猫颈椎(C2-T1)双皮质植入物最佳放置的安全通道。
回顾性分析16只猫颈椎的CT图像。使用多平面重建来确定最佳安全通道。通过植入角度、宽度和长度来定义安全通道。还描述了椎体内部的插入点。使用多级线性回归比较不同椎体之间的椎体测量值,并使用配对样本Wilcoxon符号秩检验比较椎体内左右测量值。所有分析中,P值<0.05被认为具有统计学意义。
安全通道插入点位于C2椎体尾侧三分之一处(平均颅侧椎体比例0.73)以及C3-T1椎体颅侧三分之一处(平均颅侧椎体比例0.34-0.38)。平均安全通道宽度从C2的1.04mm到C7和T1的2.30mm不等。C2的平均左右最佳植入角度分别为21.79°和21.49°,C3为45.26°和46.19°,C4为51.48°和51.04°,C5为53.52°和54.30°,C6为56.36°和56.65°,C7为63.40°和64.92°,T1为53.90°和52.90°。几乎每个测量值在不同椎体之间都存在统计学显著差异。
猫颈椎的安全通道狭窄,与犬类中报道的不同。安全通道位于C2的尾侧三分之一和C3-T1椎体的颅侧三分之一处。由于1.5-2mm的植入物对于大多数猫颈椎的双皮质植入来说尺寸过大,当前关于植入物尺寸的建议应重新审视。