Pedicle screws implantation in polymethylmethacrylate construct to stabilise sixth lumbar vertebral body fracture in dogs: 5 cases (2015-2018)

Authors
E Gougeon, P Meheust
Journal
J Small Anim Pract. 2021 Jul 27. doi: 10.1111/jsap.13400.

Objectives: To assess the feasibility and outcome of pedicle screw implantation on sixth lumbar vertebral body fractures.

Materials and methods: Dogs with sixth lumbar vertebral body fractures stabilised using L6 and L7 (±L5) pedicular implantation via a dorsal approach preferentially and conventional vertebral body implantation otherwise were reviewed. Coaptation was made with bone cement. Complete neurological examination, pre and postoperative imaging consistent with L6 body fracture (radiographs ± CT scan) and follow up including clinical examination and radiographs 3 to 5 weeks post-operatively were required as inclusion criteria. When available, owner interview and/or clinical examination and imaging (radiographs ± CT scan) at least 1 year after surgery were reported.

Results: Five dogs met the inclusion criteria. Dorsal pedicle screws implantation was feasible in all L7 vertebrae and in four L6 vertebrae. Adequate implantation was observed in all of the post-operative radiographs and on all of the three CT scans available. At 3 to 6 weeks after surgery, neurological status and locomotion were normal in four dogs, while one dog suffering from severe sciatic neuropathy did not regain normal locomotion. At least 1 year after surgery, clinical outcome was excellent for four dogs and imaging by radiography and CT scan were available for three dogs and showed complete healing of the fracture and correct positioning of the implants. The dog suffering from sciatic neuropathy had a further trauma and was euthanased 7 weeks after the surgery.

Clinical significance: In this case series, pedicle screw implantation achieved stabilisation of L6 vertebral body fractures, with full recovery observed in four out of five dogs. Further studies are required to confirm the safety and the effectiveness of this intervention.