用器械笼牵引固定治疗退行性腰骶管狭窄犬腰骶融合

VCOT Open Pub Date : 2020-07-01 DOI:10.1055/s-0040-1713824
T. R. Reints Bok, L. V. van Stee, K. Willemsen, M. Beukers, G. Grinwis, B. Meij
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引用次数: 0

摘要

本研究旨在评估使用椎间笼和椎弓根螺钉棒固定(PSRF)手术撑开和稳定后的长期疗效和椎间融合,以治疗严重退行性腰骶管狭窄(DLSS)的狗。退行性腰骶管狭窄是一种常见的疾病,在大品种的狗和有一个多因素的起源。背椎板切除术和椎间盘切除术的手术治疗结果是神经结构减压,但当应用牵张固定时,最终目的是椎体融合。1例4岁男性绝育Leonberger,表现为DLSS和既往存在的慢性脊柱炎,采用背椎板切除术、部分椎间盘切除术、刮除终板、椎间间隔器撑开(SynCage)和PSRF治疗。术后26个月,赫尔辛基疼痛评分和神经格里菲斯评分均有改善;然而,这只狗不久就因为一种无关的疾病去世了。腰骶段可用于计算机断层扫描(CT),显微CT和组织病理学。在CT上,通过笼最大孔的骨体积为91.0%,致密骨体积为76.1%。显微ct和组织病理学显示椎体融合。在这只患有严重DLSS的狗中,使用椎间间隔器和PSRF进行分心固定是被广泛接受的,并且经过长期随访,狗的临床结果很好。CT、micro-CT及组织病理学显示椎体融合。
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Lumbosacral Fusion Using Instrumented Cage Distraction–Fixation in a Dog with Degenerative Lumbosacral Stenosis
Abstract This study aimed to assess the long-term outcome and intervertebral fusion following surgical distraction and stabilization using an intervertebral cage and pedicle screw and rod fixation (PSRF) in a dog with severe degenerative lumbosacral stenosis (DLSS).Degenerative lumbosacral stenosis is a common disorder in large breed dogs and has a multifactorial origin. Surgical treatment by dorsal laminectomy and discectomy results in decompression of neural structures, but when distraction–fixation is applied, the ultimate goal is vertebral fusion. A 4-year-old male neutered Leonberger, presented with DLSS and pre-existent chronic discospondylitis, was treated by dorsal laminectomy, partial discectomy, curettage of the end plates, distraction with an intervertebral spacer (SynCage), and PSRF. At 26 months after surgery, the Helsinki pain score and neurological Griffith score were improved; however, the dog passed away shortly thereafter due to an unrelated disorder. The lumbosacral segment became available for computed tomography (CT), micro-CT and histopathology. On CT, bone volume through the largest hole of the cage was 91.0% and for compact bone 76.1%. Micro-CT and histopathology revealed vertebral fusion. Distraction–fixation using an intervertebral spacer and PSRF was well-accepted in this dog with severe DLSS, and the dog had a good clinical outcome with long-term follow-up. CT, micro-CT and histopathology showed evidence of vertebral fusion.
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