Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Translational Medicine Institute, Veterinary Teaching Hospital, Colorado State University, Fort Collins, CO, USA.
Equine Vet J. 2022 Mar;54(2):347-358. doi: 10.1111/evj.13449. Epub 2021 May 3.
Further development of surgical techniques for equine cervical stabilisation is necessary to make the procedure less technically demanding, reduce complications and improve outcomes.
To describe clinical outcomes and owner reports in horses undergoing placement of an interbody fusion device and polyaxial pedicle screw and rod construct for cervical vertebral fusion in horses with cervical vertebral compressive myelopathy.
Retrospective case series.
Data were retrieved from medical records of 10 horses undergoing cervical vertebral fusion (2015-2019). Records were evaluated for signalment, duration of clinical signs, number and location of compression sites, grade of ataxia, duration of hospitalisation and complications. Long-term follow-up was obtained through clinical re-evaluation, postoperative radiographs and owner contact.
Breeds were mixed. Median age was 24 (range 12-168) months. There were 2/10 mares, 4/10 geldings and 4/10 stallions. Preoperative grade of ataxia ranged from 1-3/5. Fusion was performed at one (n = 3) or two (n = 7) sites. Two horses were euthanised within the first year. In 6 of 8 horses with ≥1-year follow-up, ataxia improved by 1-3 grades, with an average improvement of 1.25 grades. In four horses, ataxia improved to grade 0-1. In two horses the gait was unaffected, but neck comfort improved. Complications included seroma formation (n = 9), pain (n = 5), fever (n = 4), upper respiratory tract obstruction (n = 2), azotemia (n = 2), screw breakage (n = 2), progression of neurological signs (n = 1), Horner's Syndrome (n = 1), dysphagia (n = 1), hives (n = 1), implant infection (n = 1) and nondisplaced fracture (n = 1).
Small case series, heterogeneous patient population.
This technique resulted in ≥1 grade gait improvement in 6/10 cases operated and 6/8 cases for which ≥1-year follow-up was available, similar to other methods. Fatal complications related to implant placement did not occur. This technique may represent a safer alternative to current techniques of ventral interbody fusion with similar outcomes.
为了降低手术难度、减少并发症并改善预后，有必要进一步开发马颈椎稳定化的手术技术。
描述患有颈椎压迫性脊髓病的马进行颈椎融合时，使用椎间融合器和多轴椎弓根螺钉棒系统进行颈椎融合的临床结果和马主报告。
回顾性病例系列。
从 2015 年至 2019 年接受颈椎融合术的 10 匹马的病历中检索数据。评估了马匹的品种、临床症状持续时间、压迫部位的数量和位置、共济失调程度、住院时间和并发症。通过临床再评估、术后 X 射线和马主联系获得长期随访。
品种混杂。中位年龄为 24 月龄（范围 12-168 月龄）。有 2/10 母马、4/10 阉马和 4/10 公马。术前共济失调程度为 1-3/5 级。在 1 个（n=3）或 2 个（n=7）部位进行融合。2 匹马在第 1 年内安乐死。在 8 匹至少有 1 年随访的马中，6 匹的共济失调改善了 1-3 级，平均改善了 1.25 级。4 匹马的共济失调改善到 0-1 级。在 2 匹马中，步态不受影响，但颈部舒适度改善。并发症包括血清肿形成（n=9）、疼痛（n=5）、发热（n=4）、上呼吸道阻塞（n=2）、氮质血症（n=2）、螺钉断裂（n=2）、神经症状进展（n=1）、霍纳氏综合征（n=1）、吞咽困难（n=1）、荨麻疹（n=1）、植入物感染（n=1）和无移位骨折（n=1）。
小病例系列，患者人群异质性。
与其他方法相比，该技术使 10 例手术中至少 1 级步态改善的比例为 6/10，8 例至少 1 年随访的比例为 6/8。没有发生与植入物放置相关的致命并发症。与目前的腹侧椎间融合技术相比，该技术可能是一种更安全的替代方法，具有相似的结果。
