犬寰枢椎不稳的手术矫正分析

I. Vilkovysky, I. A. Rusnak, S. A. Yagnikov, Nikolai V. Sakhno, S. B. Seleznev
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引用次数: 0

摘要

本研究分析了腹侧手术入路矫正玩具犬寰枢椎不稳的有效性。本文对135例临床手术矫治、手术通路和植入物的一般概念进行了研究,以减少医源性并发症的风险。腹侧稳定是通过从腹侧面通过关节结构和椎体插入螺钉或辐条形成寰椎与鼻尖间的关节融合术,然后用骨水泥固定。在本研究方法中,也存在金属结构失效或喉返神经损伤等并发症,但据统计,在世界实践中,这些并发症的发生率不超过20%。手术过程中可能出现的并发症包括动物因脊髓损伤引起的呼吸骤停而死亡、植入物移位或断裂、脊柱对齐不到位。此外,植入物可能放置不正确,导致慢性疼痛或脊髓损伤。术后104只狗完全恢复,13只动物神经功能缺损部分保留,18只动物术后早期死亡。17只动物出现并发症,但未导致神经状态和生活质量恶化。分析所做的工作,腹侧固定治疗寰枢椎不稳是最可靠和最佳的方法,因为它技术简单,长期效果好。统计数据显示效果良好,该方法有效,86%以上的病例可以使动物完全恢复到高质量的生活。
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Analysis of surgical correction of atlantoaxial instability in dogs
Effectiveness of ventral surgical approach in correction of atlanto-axial instability in dogs of toy breeds was analyzed in the research. 135 clinical cases of surgical correction, the general concept of surgical access and implant placement, which minimize risks of iatrogenic complications, were studied. Ventral stabilization was carried out by forming an arthrodesis between atlas and epistropheus by inserting screws or spokes through articular structures and vertebral bodies from ventral surface and then fixing them with bone cement. In the studied method, there are also complications in form of failure of metal structures or damage to recurrent laryngeal nerve, but, according to statistics, the incidence of these complications in world practice does not exceed 20 %. Among the possible complications during the operation are death of animal because of sudden respiratory arrest associated with spinal cord injury, migration or breakage of implants, inadequate alignment of spine. In addition, implants may not be placed correctly causing chronic pain or damage to the spinal cord. As a result of the operation, 104 dogs fully recovered, partial preservation of neurological deficit was observed in 13 animals, 18 animals died in the early postoperative period. Complications that did not lead to a deterioration in neurological status and quality of life occurred in 17 animals. Analyzing the work done, the method of ventral stabilization in the treatment of atlanto-axial instability can be recommended as the most reliable and optimal method, since it is technically simple and has good long-term results. Statistical data showed good results, the method is effective and allows to fully return the animal to a quality life in more than 86 % of cases.
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