Veterinary Surgery最新文献

Objective: To compare the effect of intervertebral disc (IVD) fenestration on L3/4 range of motion (ROM) under ex vivo and in vivo conditions in a rabbit model.

Study design: Randomized experimental study.

Animals: New Zealand White rabbits (ex vivo: n = 18; in vivo: n = 12).

Methods: L3/4 motion segments were tested in lateral bending (LB), flexion-extension (FE), and axial rotation (AR) across five groups (n = 6 per group): control (C), ex vivo fenestration (EVF), in vivo fenestration with a 6 (IVF6) and 12 week (IVF12) timepoint, and intact/annulotomy/fenestration on the same specimen (IAF). Data are reported as ROM and neutral zone (NZ) and were compared between groups using ANOVA and t-tests.

Results: In IAF, fenestration increased ROM in LB, FE, and AR (p = .030) and NZ in FE (p = .010) compared to intact. EVF had greater ROM and NZ than C in all planes (LB, FE: p = .0010; AR: p = .030). IVF6 and IVF12 showed reduced ROM and NZ in LB and FE compared to C (p = .020-.0010) and EVF (p = .0010), with no difference in AR (p = .35). IVF6 and IVF12 did not differ significantly in any plane. Right lateral bending was significantly greater than left in EVF (p = .020), but not in IVF6 (p = .15) or IVF12 (p = .31).

Conclusion: Fenestration increased spinal motion ex vivo, while in vivo specimens showed reduced ROM over time, consistent with a stabilizing biological response.

Clinical significance: These findings provide a foundation for investigating the biological and biomechanical effects of IVD fenestration in dogs.

Objective: To describe the outcomes of arthroscopic debridement of third carpal bone (C3) incomplete slab fractures (ISF) in racehorses.

Study design: Retrospective case study.

Sample population: Horses undergoing arthroscopic debridement of ISF of C3.

Methods: The medical records of horses surgically treated for ISF of C3 were reviewed. Age, sex, breed, limb, fracture configuration, preoperative radiographs, arthroscopic findings, postoperative intraarticular therapies, and exercise recommendations were recorded. Racing performance was obtained from online databases. Univariable analyses were used to determine associations between independent variables and outcomes.

Results: A total of 33 horses fit the criteria. There were 19 Thoroughbreds and 14 Standardbreds. The postoperative racing rate was 66.7% (22/33 horses). There was no statistically significant difference in outcome between dorsal and sagittal fractures or breeds. There were no significant differences in earnings per start or total earnings before and after surgery. Several horses showed an increase in racing frequency and an increase in earnings post-injury. Most horses, 81.8% (27/33), had at least one career start prior to undergoing surgery. The median convalescent period was 247.1 days.

Conclusion: Early diagnosis and subsequent arthroscopic debridement of C3 ISF was a viable treatment approach with a favorable prognosis for racing postoperatively.

Clinical significance: Early detection and arthroscopic debridement of ISF before progression to a complete slab fracture and/or subsequent osteoarthritis of the joint could improve athletic outcomes.

Objective: To describe the change in tibial alignment parameters and complications between bent and straight interlocking nail (ILN) fixation of diaphyseal tibial fractures in dogs.

Study design: Retrospective study.

Animals: A total of 46 dogs with trauma-induced diaphyseal tibial fractures.

Methods: Medical records of dogs with diaphyseal tibial fractures were compiled from 2014 to 2024 and categorized into bent (bILN, n = 27) and straight (sILN, n = 19) ILN groups. Tibial plateau angle (TPA), coronal angulation (CA), and medial mechanical proximal tibial angle (mMPTA) were calculated and compared with the contralateral limb. Medullary canal fill (MCF) was calculated and compared between groups. Intraoperative and postoperative complications were recorded.

Results: Postoperative TPA in the affected limb was 5° higher than in the contralateral limb in the sILN group and 1° higher in the bILN group (p < .0001, p < .0377). Postoperative affected tibias in both groups were in 2° more valgus than their contralateral limb (p < .0059, p < .0301). No differences in mMPTA were noted. The MCF was 6.6% higher in the bILN group than the sILN group (p < .0163). Only one dog in the study developed a complication: moderate ILN bending and valgus. This dog was in the bILN group.

Conclusion: The increased TPA of the sILN group could be attributed to the tibia's natural recurvatum, which a sILN may not fully accommodate.

Clinical significance: While superior tibial alignment was achieved with the bILN, the detrimental effects of a higher TPA with use of a sILN need further investigation.

Objective: To report the outcome of a dog with severe mitral regurgitation (MR) treated with open-heart surgery using the modified taut-line hitch (modified TLH) knot technique.

Methods: A 9-year-old, 8.8-kg intact male Cavalier King Charles Spaniel was referred for clinical signs of congestive heart failure secondary to severe mitral regurgitation. The dog underwent mitral valve repair under cardiopulmonary bypass. On echocardiographic examination, the left atrial-to-aortic root ratio (LA/Ao) was 2.87, and the normalized left ventricular internal diameter in diastole (LVIDdN) was 2.43. After cardiac arrest, semi-circular suture annuloplasty and chordal reconstruction using ePTFE sutures were performed. Artificial chordae lengths were adjusted using the modified TLH knot technique.

Results: Vertebral heart scores (VHS) were 15.0 (preoperatively), 12.0 (3 months), 12.3 (6 months) and 12.6 (1 year). LVIDd values were 46.1 mm (preoperatively), 33.3 mm (3 months), 34.1 mm (6 months) and 37.1 mm (1 year). LA/Ao ratios were 2.87 (preoperatively), 1.78 (3 months), 1.90 (6 months) and 1.97 (1 year). The patient remained on pimobendan (0.25 mg/kg every 12 h) at the intermediate-term follow-up, and from the 1-year evaluation, furosemide (2 mg/kg once daily) was prescribed in addition to pimobendan. At the long-term follow-up, no clinical signs of congestive heart failure were observed.

Conclusion: Mitral valve repair using the modified TLH knot technique was associated with control of clinical signs and a reduction in medical therapy requirements during long-term follow-up in a dog with severe MR.

Objective: To determine the prevalence and risk factors of surgical site infection (SSI) following internal fixation in ruminants.

Study design: Retrospective multicenter study across five veterinary teaching hospitals.

Animals: A total of 81 ruminants undergoing internal fixation for orthopedic disease.

Methods: Medical records over a 13-year period were analyzed for ruminants presenting with orthopedic disease that was surgically managed with internal fixation. Patient signalment, limb affected and type of injury, surgical method, orthopedic implants used, total anesthetic duration, antimicrobial use, development of SSI as well as short- and long-term survival were reported.

Results: The incidence of SSI was 17.3% (14/81). Overall, 92.6% (75/81) of cases survived to discharge; 85.7% (12/14) of cases with SSI and 94% (63/67) of cases that did not develop SSI. Increased duration of antimicrobial use (p = .004) and fractures distal to the tarsus/carpus (p = .04) were associated with an increased risk of SSI but had no effect on overall survival. The use of intramedullary pins for surgical repair was associated with a reduced likelihood of survival to discharge (p = .008).

Conclusion: In conclusion, the SSI incidence in ruminants following internal fixation was comparable to the infection risk in horses and camelids. SSI had a higher incidence in fractures distal to the tarsus/carpus and in animals that were administered antibiotics for a prolonged period.

Clinical significance: The use of orthopedic implants in ruminants is associated with a good outcome with 92.6% of cases surviving to discharge and a comparable incidence of surgical site infection as other large animal species.

Objective: To describe specific methods of plate application and to report outcomes for patients treated with the OrthoLine^TM system.

Study design: Retrospective case series.

Animals: A total of 65 dogs, and six cats.

Methods: Medical records of dogs and cats treated with the OrthoLine^TM system were reviewed. Cases with <12 weeks follow-up, significant comorbidities, a revision procedure, or those receiving the study implant in combination with another system were excluded. Construct application characteristics (plate span [%], plate span ratio, screw hole density, and plate working length [cm]) were calculated and compared between fracture locations. Patient outcomes included fracture healing, owner assessed outcome (telephone interview) and reported complications from owner interviews and medical records.

Results: A total of 75 fractures in 71 cases were treated with 77 plates. Clinical union was noted in 57/61 fractures (93.4%) at a range of 1.7-19.7 weeks. Owner assessed outcome (n = 51) was graded as full or acceptable for all cases. Major complications included implant failure (n = 1), implant infection (n = 2), and intraoperative malreduction with revision (n = 1). Plate span of radial (46.6%) and ulnar (33.0%) constructs were both lower compared to femoral (73.3%) (p < .001) constructs, and ulnar constructs were also lower compared to tibial (61.7%) constructs (p = .004).

Conclusion: The OrthoLine^TM system produced acceptable radiographic healing, complication rates, and owner assessed outcomes. Shorter plate spans in the radius and ulna were well tolerated.

Clinical significance: The OrthoLine^TM system is a promising alternative for fracture repair in dogs and cats.

Objective: To evaluate the feasibility of minimally invasive integrated endoscopic mini-hemilaminectomy and thoracolumbar lateral corpectomy at six intervertebral disc spaces in the canine thoracolumbar vertebral column.

Study design: Experimental, randomized cadaveric study.

Animals: Eight cadaver dogs euthanized for reasons unrelated to this study.

Methods: Preoperative computed tomography (CT) scans were performed for surgical planning. Using an endoscopic system, mini-hemilaminectomy and thoracolumbar lateral corpectomy were performed from the T11-12 through L3-4 intervertebral disc spaces, with cadavers in sternal recumbency or positioned at a 30°-60° angle. Postoperative CT scans were used to measure corpectomy dimensions as a percentage of total vertebral dimensions.

Results: Median ± interquartile range (IQR) corpectomy dimensions were 23.07% ± 16.47% of vertebral body length, 46.76% ± 21.7% of vertebral body height, and 74.44% ± 47.37% of vertebral canal diameter. Targeted dimensions were achieved at all surgical sites from T11-12 through L3-4.

Conclusion: Integrated endoscopic thoracolumbar lateral corpectomy was successfully performed at all intervertebral disc spaces from T11-12 through L3-4 using an endoscopic system, although thoracic sites required more practice.

Clinical significance: This pilot study will guide further clinical applications of minimally invasive neurosurgery in small animal patients.

Objective: To evaluate the effect of a simple chest wall-lifting technique on thoracic volumes in cats.

Study design: Cadaveric study.

Animals: Feline cadavers (n = 8).

Methods: Animals underwent thoracic computed tomography (CT) scans after each treatment: in lateral recumbency, (1) no lift and (2) intercostal space lift, and in dorsal recumbency, (1) no lift and (2) sternal lift. Lifting was performed in lateral recumbency at the eighth intercostal space using a bent 2 mm Steinmann pin and in dorsal recumbency at mid-sternum using a Backhaus towel clamp, placed under thoracoscopic guidance until maximal effect was subjectively noted while recording the tension achieved on the device. Thoracic cavity volume (TCV), working space volume (WSV), and ventilation space volume (VSV) were determined on CT images and compared across treatments.

Results: The TCV increased by a median of 27% (range: 7%-72%), 54% (28%-64%), and 51% (37%-106%) in the dorsal, left lateral, and right lateral recumbencies, respectively. The WSV showed a median increase of 92% (-21%-1026%), 187% (113%-355%), and 271% (119%-422%) for the same positions. In contrast, the VSV decreased, and although statistically significant, the change was relatively minor, with a median decrease of 3% (range: -5%-19%), 7% (-1%-18%), and 7% (3%-11%) in the dorsal, left lateral, and right lateral recumbencies, respectively.

Conclusion: Chest wall lifting increased the WSV in feline cadavers with minimal impact on the VSV.

Clinical significance: This novel and simple technique could help in performing thoracoscopic procedures in cats.

Objective: The objective of the present study was to report the outcome of a novel technique of urethral intra-abdominal anastomosis after transabdominal wall passage of the penis in a dog with stent-related urethral obstruction.

Study design: Case report.

Animal: A seven-year-old neutered male Cocker Spaniel.

Methods: The dog was evaluated for urinary retention and overflow incontinence of approximately 1-year duration. The dog had a urethral self-expanding metallic stent placed 6 years prior as treatment for pelvic urethral stricture, secondary to severe pelvic trauma. Stent fracture and stent-related tissue hyperplasia were diagnosed leading to intrapelvic urethral obstruction and concomitant atonic bladder complicated by cystolithiasis and urinary tract infection. An intra-abdominal urethral anastomosis was performed to restore urethral patency, after passing the penis through the abdominal wall, into the inguinal area; the surgery was successful in bypassing the urethral obstruction.

Results: No contrast leakage was noted on positive contrast cystourethrography 10 days postoperatively. The urinary bladder was easily emptied by manual expression and bethanechol was started. At 6-months follow-up, the urinary bladder remained atonic but was easily emptied by manual expression, with mild urinary incontinence remaining. No signs of recurrent urinary tract infections were noted. Nine months after surgery the dog was euthanized for reasons unrelated to the surgery.

Conclusion: The transabdominal wall urethral anastomosis, after penile abdominal tunnelization resulted in bypassing the urethral obstruction in this dog, restoring urethral patency. The technique reported could be a viable surgical option for restoring urethral patency in dogs with severe pelvic urethral damage or obstructive lesions.