Outcome of Ventral Fusion of Two or Three Cervical Vertebrae with a Locking Compression Plate for the Treatment of Cervical Stenotic Myelopathy in Eight Horses

Vet Comp Orthop Traumatol. 2018 Sep;31(5):356-363. doi: 10.1055/s-0038-1666979. Epub 2018 Aug 23.

Abstract

Objectives: It was recently shown that biomechanical stability achieved with a locking compression plate (LCP) for ventral cervical fusion in horses is similar to the commonly used Kerf cut cylinder. The advantages of the LCP system render it an interesting implant for this indication. The goal of this report was to describe surgical technique, complications and outcome of horses that underwent ventral fusion of two or three cervical vertebrae with an LCP.

Methods: Medical records of eight horses were reviewed for patient data, history, preoperative grade of ataxia, diagnostic imaging, surgical technique and complications. Follow-up information was obtained including clinical re-examination and radiographs whenever possible.

Results: Two (n = 5) or 3 (n = 3) cervical vertebrae were fused in a mixed population with a median age of 9 months, median weight of 330 kg and median grade of ataxia of 3/5. A narrow 4.5/5.0 LCP (n = 6), a broad 4.5/5.0 LCP (n = 1) and a human femur 4.5/5.0 LCP (n = 1) were applied. Two horses were re-operated due to implant loosening. Six patients developed a seroma. Long-term complications included ventral screw migration in four, spinal cord injury in one and plate breakage in two horses at 720 to 1116 days after surgery. Outcome was excellent in three, good in four, poor in one patient.

Clinical significance: The use of an LCP for ventral cervical vertebral fusion is associated with good clinical results. However, a careful surgical technique is required to further reduce the complication rate.

MeSH terms

  • Animals
  • Bone Plates / veterinary*
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery*
  • Female
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / surgery*
  • Horses
  • Male
  • Radiography / veterinary
  • Spinal Fusion / instrumentation
  • Spinal Fusion / methods
  • Spinal Fusion / veterinary*
  • Spinal Stenosis / diagnostic imaging
  • Spinal Stenosis / surgery
  • Spinal Stenosis / veterinary*
  • Tomography, Spiral Computed / veterinary