Schulze Nicole, Ehrle Anna, Weller Renate, Fritsch Guido, Gernhardt Jennifer, Ben Romdhane Recem, Lischer Christoph
Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany.
Department of Clinical Sciences and Services, Royal Veterinary College, London, United Kingdom.
Vet Comp Orthop Traumatol. 2020 Jan;33(1):1-8. doi: 10.1055/s-0039-1693665. Epub 2019 Aug 6.
Surgical fusion of vertebral segments is a treatment option for horses with cervical stenotic myelopathy or cervical fracture.Degenerative disease affecting adjacent vertebral segments is a reported complication following surgical vertebral fusion in other species, termed adjacent segment disease. The aim of this study was to evaluate the impact of cervical vertebral fusion on the biomechanics of adjacent vertebral segments in the horse.
Neck specimens of 12 horses were assessed using computed tomographic imaging. Range of motion (ROM) was determined by measuring the maximum sagittal flexion, extension and lateral bending between C2 and C5. C3/4 was subsequently fused using a standard locking compression plate and locking head screws and computed tomographic scans and ROM measurements were repeated.
Prior to intervertebral fusion, a significant increase in ROM along the vertebral segments from cranial to caudal was observed. Range of motion measurements of C3/4 decreased significantly after fusion ( = 0.01).Range of motion of the adjacent segments (C2/3 and C4/5) did not change significantly after fusion.
Fusion of one cervical intervertebral joint did not affect the ROM of the adjacent vertebral segments. Further research investigating the implications of vertebral fusion on the intervertebral pressure in the equine patient is indicated.
椎体节段性手术融合是治疗患有颈椎管狭窄性脊髓病或颈椎骨折马匹的一种选择。在其他物种中，手术椎体融合后出现的一种并发症是影响相邻椎体节段的退行性疾病，称为相邻节段疾病。本研究的目的是评估颈椎融合对马相邻椎体节段生物力学的影响。
使用计算机断层扫描成像评估12匹马的颈部标本。通过测量C2和C5之间的最大矢状面屈曲、伸展和侧弯来确定活动范围（ROM）。随后使用标准锁定加压钢板和锁定头螺钉对C3/4进行融合，并重复计算机断层扫描和ROM测量。
在椎间融合之前，观察到沿椎体节段从颅侧到尾侧的ROM显著增加。融合后C3/4的活动范围测量值显著降低（P = 0.01）。融合后相邻节段（C2/3和C4/5）的活动范围没有显著变化。
一个颈椎椎间关节的融合不会影响相邻椎体节段的ROM。表明需要进一步研究探讨椎体融合对马患者椎间压力的影响。
