Comparison of Two Surgical Techniques for the Treatment of Canine Disc Associated-Cervical Spondylomyelopathy

Abstract

Objective: To compare prosthetic disc and vertebral distraction stabilization in dogs with disc-associated cervical spondylomyelopathy (DA-CSM).

Study design: A retrospective clinical study.

Animals: 25 dogs.

Methods: Dogs presenting with clinical signs and MRI findings compatible with DA-CSM underwent surgery. Implantation of the Adamo's prosthetic disc (PD) or vertebral distraction-stabilization (DS) with intervertebral cage, ventral locking plates, and dorsal transarticular screws was performed. All dogs were followed-up and evaluated clinically for a minimum of 1 year and radiographically for at least 3 months. In particular, we focused on the evaluation of subsidence (the degree of vertebral collapse).

Results: Twenty-five dogs were enrolled: 12 with PD implantation and 13 with DS implantation. Of these, 24 dogs were followed-up at 1 year. Overall, 12 dogs improved (4 PD and 8 DS), eight were stable (4 PD and 4 DS), and four deteriorated (3 PD and 1 DS). Deterioration was more common in PD cases, especially soon after surgery. In a few PD cases, a second surgery was necessary. The most common complication in dogs with DS was discospondylitis. Subsidence was detected in 11 PD and 7 DS dogs. Subsidence was more severe and occurred sooner after surgery in PD cases compared to DS cases. DS cases were more prone to clinical improvement and less prone to subsidence than PD cases in this study. However, the statistical evidence was weak owing to the small sample size.

Conclusion: The preliminary results suggest that prosthetic disc implantation is more prone to clinical and radiographic failures than distraction stabilization.

Clinical relevance: The DS technique is a valuable surgical option for treating dogs with DA-CSM, with favorable short- and long-term clinical and radiographic outcomes.

Keywords: Wobbler syndrome; cervical spondylomyelopathy (CSM); distraction stabilization; prosthetic disc; surgical procedures.

Figure 1

Lateral pre-operative (A) and post-operative (B) radiographic views of a dog with prosthetic disc implantation.

Figure 2

Lateral pre-operative (A) and post-operative (B) and ventro-dorsal post-operative (C) radiographic views of a dog with distraction-stabilization using intervertebral cage, two parallel ventral locking plates, and two dorsal trans-articular screws.

Figure 3

Same dog as in Figure 1, with severe neurological deterioration and subsidence at 9 days after surgery.

Figure 4

Latero-lateral radiographs of the same dog before a PD surgery (left image), at 30 days post-op (middle image) and at 90 days post-op (right image).

Figure 5

Same dog as in Figure 2, with one screw rupture at 90 days radiographic recheck.

Figure 6

Sagittal T2 weighted images of a DA-CSM-dog, pre- (A) and post-traction (B) and 3 months post DS-surgery (C); from left to right sagittal T2 Weighted and STIR Images of an example of discospondylitis at C5–C6, in a patient previously treated by DS at C6–C7 (D).

Figure 7

Graphical representation of neurological status within 30 days of surgery (A), after 30 days and within 1 year (B) and over 1 year, defined as improved, stable, or worse.