Schmidli Fenella E, Stein Veronika M, Aikawa Takeshi, Boudrieau Randy J, Jeandel Aurelien, Jeffery Nicholas, Jurina Konrad, Moissonnier Pierre, Rupp Stefan, Vidondo Beatriz, Forterre Franck
Department of Clinical Veterinary Medicine, Vetsuisse Faculty, Bern, Switzerland.
Aikawa Veterinary Medical Center, Tokyo, Japan.
Vet Comp Orthop Traumatol. 2019 May;32(3):200-206. doi: 10.1055/s-0039-1678542. Epub 2019 May 17.
In human medicine, fractures of the second cervical vertebra have been studied elaborately and categorized in detail. This is not the case in veterinary medicine where clinical decisions are often based on old studies focusing on the cervical spine in general.
The aim of this study was to describe the clinical features, fracture types, therapeutic options and outcome of dogs and cats with a fractured axis.
The present study was a multi-institutional retrospective case series.
Crossbreeds and Labrador Retrievers were the most represented dog breeds. Median age was 2 years. Motor vehicle accident was the most common inciting cause, followed by frontal collision. The most common neurological deficits ranged from cervical pain with or without mild ataxia (22/68) to tetraparesis (28/68) and tetraplegia (11/68). Concerning treatment, 37 of 69 patients underwent surgical fracture stabilization, 27/69 received conservative therapy and 5/69 were immediately euthanatized. Of all treated cases, 52/58 showed ambulatory recovery (23/25 of the conservatively treated and 29/33 of the surgically treated cases), whereby in 40/52 cases full recovery without persisting signs was achieved.
Fractures of the axis commonly occur in young dogs. In many cases, neurological deficits are relatively mild. Generally, animals with a fractured axis have a very good prognosis for functional recovery. The risk of perioperative mortality is considerably lower than previously reported.
在人类医学中,第二颈椎骨折已得到详尽研究并进行了详细分类。而在兽医学领域情况并非如此,临床决策往往基于以往针对整个颈椎的研究。
本研究旨在描述患有枢椎骨折的犬猫的临床特征、骨折类型、治疗选择及预后情况。
本研究为多机构回顾性病例系列研究。
杂种犬和拉布拉多寻回犬是最具代表性的犬种。中位年龄为2岁。机动车事故是最常见的诱发原因,其次是正面碰撞。最常见的神经功能缺损范围从伴有或不伴有轻度共济失调的颈部疼痛(22/68)到四肢轻瘫(28/68)和四肢瘫痪(11/68)。关于治疗,69例患者中有37例接受了手术骨折固定,27/69接受了保守治疗,5/69立即实施了安乐死。在所有接受治疗的病例中,52/58显示可恢复行走(保守治疗的23/25和手术治疗的29/33),其中40/52例实现了完全恢复且无持续症状。
枢椎骨折常见于幼犬。在许多情况下神经功能缺损相对较轻。一般来说,患有枢椎骨折的动物功能恢复预后非常好。围手术期死亡率风险比先前报道的要低得多。