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一匹温血种公马第六颈椎骨折关节突的计算机辅助手术内固定

Internal fixation of a fractured cranial articular process of the sixth cervical vertebra by means of computer-assisted surgery in a Warmblood gelding.

作者信息

Käfer-Karrer Melanie J, de Preux Mathieu, Van der Vekens Elke, Mattei Larissa I, Kuhlmann Jovana, Klopfenstein Bregger Micaël D, Easley Jeremiah T, Koch Christoph

机构信息

Division of Equine Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

出版信息

Vet Surg. 2025 Jul;54(5):920-929. doi: 10.1111/vsu.14273. Epub 2025 May 23.

Abstract

OBJECTIVES

To describe the repair of a fractured cranial articular process (AP) of the sixth cervical vertebra (C6) with cortex screws placed in lag fashion using computer-assisted surgery.

ANIMAL

A 12-year-old Swiss Warmblood gelding.

STUDY DESIGN

Case report.

METHODS

The gelding was presented with neck pain and ataxia after a fall. A fracture of the right cranial AP of C6 was identified on radiographs. The fracture was repaired by internal fixation with two 4.5 mm cortex screws of 58 and 48 mm length placed in lag fashion using computer-assisted surgery.

RESULTS

During general anesthesia, it was suspected that the gelding developed brain edema that prolonged the recovery process. Postoperatively, the horse showed transient ataxia and myopathy of the left triceps muscle. Except for focal muscular atrophy of the right supraspinatus muscle, all complications resolved. Radiographs confirmed healing of the fracture with minimal callus formation. One year after surgery, the gelding had returned to ridden exercise and was performing well.

CONCLUSION

Computer-assisted surgery facilitates lag screw fixation of AP fractures and makes this a potential alternative to intervertebral body fusion, which is recommended for this type of fracture to avoid excessive callus formation and subsequent spinal cord or cervical spinal nerve compression.

摘要

目的

描述使用计算机辅助手术以拉力螺钉方式置入皮质骨螺钉修复第六颈椎(C6)颅骨关节突(AP)骨折的情况。

动物

一匹12岁的瑞士温血种公马。

研究设计

病例报告。

方法

这匹种公马在摔倒后出现颈部疼痛和共济失调。X线片显示C6右侧颅骨关节突骨折。使用计算机辅助手术,以拉力螺钉方式置入两枚长度分别为58和48毫米的4.5毫米皮质骨螺钉进行内固定修复骨折。

结果

全身麻醉期间,怀疑这匹种公马出现脑水肿,延长了恢复过程。术后,该马出现短暂共济失调和左侧肱三头肌肌病。除右侧冈上肌局部肌肉萎缩外,所有并发症均已解决。X线片证实骨折愈合,骨痂形成极少。术后一年,这匹种公马已恢复骑乘训练,表现良好。

结论

计算机辅助手术有助于AP骨折的拉力螺钉固定,使其成为椎体间融合术的一种潜在替代方法,对于此类骨折推荐采用椎体间融合术以避免过多骨痂形成及随后的脊髓或颈脊神经受压。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d83/12282041/0af17fe26b0c/VSU-54-920-g006.jpg

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