Spinal fracture and luxation in dogs and cats

Summary

The purpose of this retrospective study was to review cases of spinal fractures or luxations (SFL) treated with various modalities in order to describe fracture location, neurological status, treatment, outcome and complications in a patient population at a single centre. Medical records of dogs and cats diagnosed with a SFL between C1 and L7 between January 1995 and June 2005 were reviewed to collect pertinent data. Ninety-five cases were included in this study. Severity of spinal cord injury was graded on a scale from 0 to 5. Vehicular trauma was the most common cause of SFL. Spinal fractures were localized between C1-C5 in 10 cases, C6-T2 in 1 case, T3-L3 in 54 cases, L4-L7 in 36 cases. Thirty patients euthanized without treatment had a median neurological score of 5. Twenty-eight patients, all of which had motor function, were treated conservatively and there was not any change in their median neurological grade at the time of discharge.. Thirty-seven patients had surgery, 27 of which were non ambulatory. Thirty-five of 37 were stabilized using pins and/or screws and PMMA or various other techniques. The median neurological grade of surgically treated patients improved by one point between the time of initial diagnosis and discharge. Implant removal was performed in 5 cases. Patients treated with pins and/or screws and PMMA were significantly more improved than conservatively managed patients at the time of discharge, although the surgically treated patients were hospitalized significantly longer than conservatively managed patients. Our results suggest that dogs that retain pain sensation prior to surgery have a good prognosis for functional recovery. In this study, dogs that were treated conservatively retained purposeful movement and had a good prognosis for recovery.

Keywords

Spinal - fracture - luxation - dog - Cat

• References

• 1 Matthiesen DT. Thoracolumbar spinal fractures/ luxations: Surgical management.. Comp Cont Ed Sm Anim Pract 1983; 5: 867-878.
• 2 Turner WD. Fractures and fracture-luxations of the lumbar spine: A retrospective study in the dog.. J Am An Hosp Assoc 1987; 23: 459-464.
• 3 Selcer RR, Bubb WJ, Walker TL. Management of vertebral column fractures in dogs and cats: 211 cases (1977-1985).. J Am Vet Med Assoc 1991; 198: 1965-1968.
• 4 Hawthorne JC, Blevins WE, Wallace LJ. et al. Cervical vertebral fractures in 56 dogs: A retrospective study.. J Am An Hosp Assoc 1999; 35: 135-146.
• 5 McKee WM. Spinal trauma in dogs and cats: Review of 51 cases.. Vet Rec 1990; 126: 285-289.
• 6 Carberry CA, Flanders JA, Dietze AE. Nonsurgical management of thoracic and lumbar spinal fractures and fracture / luxations in the dog and cat: A review of 17 cases.. J Am An Hosp Assoc 1989; 25: 43-54.
• 7 Smeak DD, Olmstead ML. Fracture / luxations or sacrococcygeal area in the cat a retrospective study of 51 cases.. Vet Surg 1985; 14: 319-324.
• 8 Roaf R. A study of the mechanics of spinal injuries.. J Bone Joint Surg 1960; 42: 810-823.
• 9 Bruecker KA, Seim HBI. Principles of spinal fracture management.. Semin Vet Med Surg (Small Anim) 1992; 7: 71-84.
• 10 Sharp NJH, Wheeler S. Trauma.. In: Small Animal Spinal Disorders Diagnosis and Surgery. Sharp NJH, Wheeler S (eds). Toronto: Elsevier Mosby; 2005: 281-318.
• 11 LeCouteur RA, Sturgess B. Spinal fractures and luxations.. In: Textbook of Small Animal Surgery. 3rd ed. Slatter D, (ed). Philadelphia: Elsevier Science; 2003: 1244-1260.
• 12 Walker TM, Pierce WA, Welch RD. External fixation of the lumbar spine in a canine model.. Vet Surg 2002; 31: 181-188.
• 13 Dulisch ML, Withrow SJ. The use of plastic plates for fixation of spinal fractures in the dog.. Can Vet J 1979; 20: 326-332.
• 14 Grasmueck S, Steffen F. Survival rates and outcomes in cats with thoracic and lumbar spinal cord injuries due to external trauma.. J Sm An Pract 2004; 45: 284-288.
• 15 Olby N, Levine J, Harris T. et al. Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord:87 cases (1996-201).. J Am Vet Med Assoc 2003; 222: 762-769.
• 16 Rechtine GR. Nonoperative management and treatment of spinal injuries.. Spine 2006; 31 (Suppl) s22-s27.
• 17 Fehlings MG, Perrin RG. The timing of surgical intervention in the treatment of spinal cord injury: A systematic review of recent clinical evidence. Spine 2006; 31 (Suppl) s28-s35.
• 18 La Rosa G, Conti A, Cardali S. et al. Does early decompression improve neurological outcome of spinal cord injured patients? Appraisal of the literature using a meta-analytical approach.. Spinal Cord 2004; 42: 503-512.
• 19 Waldron DR, Shires PK, McCain W. et al. The rotational stabilizing effect of spinal fixation techniques in an unstable vertebral model.. Prog Vet Neuro 1991; 2: 105-110.
• 20 Stone EA, Betts CW, Chambers JN. Cervical fractures in the dog: A literature and case review.. J Am An Hosp Assoc 1979; 15: 463-471.
• 21 Blass CE, Waldron DR, van Ee RT. Cervical stabilization in three dogs using steinmann pins and methylmethacrylate.. J Am An Hosp Assoc 1986; 24: 61-68.
• 22 Wheeler JL, Cross AR, Rapoff AJ. A comparison of the accuracy and safety of vertebral body pin placement using a fluoroscopically guided versus an open surgical approach: An in vitro study.. Vet Surg 2002; 31: 468-474.
• 23 Fisher CG, Noonan VK, Dvorak MF. Changing Face of Spine Trauma Care in North America.. Spine 2006; 31: s2-s8.