Ellison G W, Seim H B, Clemmons R M
Department of Surgical Sciences, College of Veterinary Medicine, JHMHC, University of Florida, Gainesville 32610.
J Am Vet Med Assoc. 1988 Aug 15;193(4):447-53.
Using an autogenous bone graft (obtained from the iliac crest), 4-mm cancellous bone screws, and polymethylmethacrylate, a distracted cervical spinal fusion technique was performed on 10 dogs with myelographic evidence of caudal cervical spondylomyelopathy. All dogs had evidence of dynamic soft tissue spinal cord compression, as indicated by flexion, extension, and traction myelographic views. Of the 10 dogs, 4 previously had undergone surgery by use of ventral slot or cervical disk fenestration techniques, and their neurologic status had deteriorated after the original surgery. Preoperative neurologic status of the 10 dogs included nonambulatory tetraparesis (n = 5), severe ataxia with conscious proprioceptive deficits (n = 2), and mild ambulatory ataxia with conscious proprioceptive deficits (n = 3). Five dogs had signs of various degrees of cervical pain. Clinical improvement was observed in 8 of 10 dogs--either improved neurologic status or elimination of cervical pain. Implant loosening developed in 3 dogs; 2 of them were euthanatized because of lack of neurologic improvement. Radiographic evidence of bony cervical fusion was observed during a 9- to 24-week period in 6 of the 8 surviving dogs. The distracted cervical fusion technique appears to be a valid surgical procedure to manage cervical spondylomyelopathy in those dogs in which the lesions are limited to one cervical intervertebral disk space.
采用取自髂嵴的自体骨移植、4毫米的松质骨螺钉和聚甲基丙烯酸甲酯，对10只经脊髓造影证实患有颈髓型颈椎病的犬实施了撑开式颈椎融合技术。所有犬在屈伸和牵引脊髓造影视图中均显示有动态软组织脊髓压迫迹象。10只犬中，4只先前已接受过腹侧开槽或颈椎间盘开窗手术，且其神经状态在初次手术后恶化。10只犬的术前神经状态包括不能行走的四肢轻瘫（n = 5）、伴有意识性本体感觉缺陷的严重共济失调（n = 2）以及伴有意识性本体感觉缺陷的轻度行走性共济失调（n = 3）。5只犬有不同程度的颈部疼痛迹象。10只犬中有8只观察到临床改善——神经状态改善或颈部疼痛消除。3只犬出现植入物松动；其中2只因神经状态未改善而实施安乐死。在8只存活犬中的6只，于9至24周期间观察到颈椎融合的影像学证据。撑开式颈椎融合技术似乎是治疗病变局限于一个颈椎间盘间隙的犬的颈髓型颈椎病的一种有效手术方法。
