Vet Comp Orthop Traumatol 2020; 33(01): 001-008
DOI: 10.1055/s-0039-1693665
Original Research
Georg Thieme Verlag KG Stuttgart · New York

Computed Tomographic Evaluation of Adjacent Segment Motion after Ex Vivo Fusion of Equine Third and Fourth Cervical Vertebrae

Nicole Schulze
1   Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
,
Anna Ehrle
1   Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
,
Renate Weller
2   Department of Clinical Sciences and Services, Royal Veterinary College, London, United Kingdom
,
Guido Fritsch
3   Leibniz Institute for Zoo and Wildlife Research in the Forschungsverbund Berlin e.V., Berlin, Germany
,
Jennifer Gernhardt
1   Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
,
Recem Ben Romdhane
4   Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany
,
Christoph Lischer
1   Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
› Author Affiliations
Funding Funding for this study was provided by the European College of Veterinary Surgeons (ECVS Residents Research Grant).
Further Information

Publication History

19 December 2018

05 June 2019

Publication Date:
06 August 2019 (online)

Abstract

Objective Surgical fusion of vertebral segments is a treatment option for horses with cervical stenotic myelopathy or cervical fracture.

Degenerative disease affecting adjacent vertebral segments is a reported complication following surgical vertebral fusion in other species, termed adjacent segment disease. The aim of this study was to evaluate the impact of cervical vertebral fusion on the biomechanics of adjacent vertebral segments in the horse.

Study Design Neck specimens of 12 horses were assessed using computed tomographic imaging. Range of motion (ROM) was determined by measuring the maximum sagittal flexion, extension and lateral bending between C2 and C5. C3/4 was subsequently fused using a standard locking compression plate and locking head screws and computed tomographic scans and ROM measurements were repeated.

Results Prior to intervertebral fusion, a significant increase in ROM along the vertebral segments from cranial to caudal was observed. Range of motion measurements of C3/4 decreased significantly after fusion (p = 0.01).

Range of motion of the adjacent segments (C2/3 and C4/5) did not change significantly after fusion.

Conclusion Fusion of one cervical intervertebral joint did not affect the ROM of the adjacent vertebral segments. Further research investigating the implications of vertebral fusion on the intervertebral pressure in the equine patient is indicated.

Authors' Contributions

All authors contributed to the study design and interpretation of the data. N. Schulze, A. Ehrle and C. Lischer were mainly responsible for the planning of the project as well as data acquisition, analysis and interpretation. G. Fritsch and J. Gernhard contributed to the study execution and data analysis. R. Weller developed the described image analysis and R. Ben Romdhane was mainly responsible for data acquisition and statistical analysis. All authors approved the final version of the manuscript.


 
  • References

  • 1 Aldrich E, Nout-Lomas Y, Seim III HB, Easley JT. Cervical stabilization with polyaxial pedicle screw and rod construct in horses: a proof of concept study. Vet Surg 2018; 47 (07) 932-941
  • 2 Bergmann W, Bergknut N, Veraa S. , et al. Intervertebral disc degeneration in warmblood horses: morphology, grading, and distribution of lesions. Vet Pathol 2018; 55 (03) 442-452
  • 3 Clayton HM, Townsend HG. Kinematics of the cervical spine of the adult horse. Equine Vet J 1989; a; 21 (03) 189-192
  • 4 Zsoldos RR, Licka TF. The equine neck and its function during movement and locomotion. Zoology (Jena) 2015; 118 (05) 364-376
  • 5 Krüger W. Über Schwingungen der Wirbelsäule – Insbesondere der Wirbelbrücke- des Pferdes Während der Bewegung. Berl Munch Tierarztl Wochenschr 1939; 13: 129-133
  • 6 Mosby's Medical Dictionary. 9th ed. St. Louis: Mosby Elsevier; 2013
  • 7 Yoon DH, Yi S, Shin HC, Kim KN, Kim SH. Clinical and radiological results following cervical arthroplasty. Acta Neurochir (Wien) 2006; 148 (09) 943-950
  • 8 Bainbridge D. The normal anatomy of the neck. In: Henson FMD. , ed. Equine neck and back pathology. 2nd ed. Oxford: John Wiley & Sons Ltd; 2018: 1-7
  • 9 Zsoldos RR, Groesel M, Kotschwar A, Kotschwar AB, Licka T, Peham C. A preliminary modelling study on the equine cervical spine with inverse kinematics at walk. Equine Vet J Suppl 2010; 42 (38) 516-522
  • 10 Grant BD, Barbee DD, Wagner PC. , et al. Long term results of surgery for equine cervical vertebral malformation. Proc. Amer Assoc Equine Pract. 1985; 31: 91-96
  • 11 Walmsley J. Surgical treatment of cervical spinal cord compression in horses: a European experience. Equine Vet Educ 2005; 17: 39-43
  • 12 Moore BR, Reed SM, Robertson JT. Surgical treatment of cervical stenotic myelopathy in horses: 73 cases (1983-1992). J Am Vet Med Assoc 1993; 203 (01) 108-112
  • 13 Reardon R, Kummer M, Lischer C. Ventral locking compression plate for treatment of cervical stenotic myelopathy in a 3-month-old warmblood foal. Vet Surg 2009; 38 (04) 537-542
  • 14 Reardon RJ, Bailey R, Walmsley JP, Heller J, Lischer C. An in vitro biomechanical comparison of a locking compression plate fixation and kerf cut cylinder fixation for ventral arthrodesis of the fourth and the fifth equine cervical vertebrae. Vet Surg 2010; 39 (08) 980-990
  • 15 Ahmed M, Tameem E. Risk factors for adjacent segment disease development after cervical fusion. J Orthop Skeletal Med 2017; 1: 1-6
  • 16 Hakozaki T, Ichinohe T, Kanno N. , et al. Biomechanical assessment of the effects of vertebral distraction-fusion techniques on the adjacent segment of canine cervical vertebrae. Am J Vet Res 2016; 77 (11) 1194-1199
  • 17 Gellman KS, Bertram JE. The equine nuchal ligament. 2. Passive dynamic energy exchange in locomotion. Vet Comp Orthopaed 2002; 15: 7-14
  • 18 Schwab JS, Diangelo DJ, Foley KT. Motion compensation associated with single-level cervical fusion: where does the lost motion go? . Spine 2006; 31 (21) 2439-2448
  • 19 Park J, Shin JJ, Lim J. Biomechanical analysis of disc pressure and facet contact force after simulated two-level cervical surgeries (fusion and arthroplasty) and hybrid surgery. World Neurosurg 2014; 82 (06) 1388-1393
  • 20 Volkheimer D, Malakoutian M, Oxland TR, Wilke HJ. Limitations of current in vitro test protocols for investigation of instrumented adjacent segment biomechanics: critical analysis of the literature. Eur Spine J 2015; 24 (09) 1882-1892
  • 21 Panjabi MM. Biomechanical evaluation of spinal fixation devices: I. A conceptual framework. Spine 1988; 13 (10) 1129-1134
  • 22 Crisco JJ. The biomechanical stability of the human lumbar spine: experimental and theoretical investigations [Doctoral dissertation]. New Haven, CT: Yale University; 1989
  • 23 Ashman RB, Birch JG, Bone LB. , et al. Mechanical testing of spinal instrumentation. Clin Orthop Relat Res 1988; 227 (227) 113-125
  • 24 Levine JM, Levine GJ, Hoffman AG, Mez J, Bretton GR. Comparative anatomy of the horse, ox, and dog: the vertebral column and peripheral nerves. Comp Equine 2007; 1: 279-292
  • 25 David Kaye I, Hilibrand AS. Adjacent level disease-background and update based on disc replacement data. Curr Rev Musculoskelet Med 2017; 10 (02) 147-152
  • 26 Boden SD, McCowin PR, Davis DO, Dina TS, Mark AS, Wiesel S. Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990; 72 (08) 1178-1184
  • 27 Matsumoto M, Fujimura Y, Suzuki N. , et al. MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg Br 1998; 80 (01) 19-24
  • 28 Matsunaga S, Kabayama S, Yamamoto T, Yone K, Sakou T, Nakanishi K. Strain on intervertebral discs after anterior cervical decompression and fusion. Spine 1999; 24 (07) 670-675
  • 29 Eck JC, Humphreys SC, Lim TH. , et al. Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion. Spine 2002; 27 (22) 2431-2434
  • 30 Dmitriev AE, Cunningham BW, Hu N, Sell G, Vigna F, McAfee PC. Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: an in vitro human cadaveric model. Spine 2005; 30 (10) 1165-1172
  • 31 Nixon AJ, Stashak TS, Ingram JT, Norrdin RW, Park RD. Cervical intervertebral disk protrusion in a horse. Vet Surg 1984; 13: 154-158
  • 32 Jeffcott LB, Dalin G. Natural rigidity of the horse's backbone. Equine Vet J 1980; 12 (03) 101-108
  • 33 Foss RR, Genetzky RM, Riedesel EA, Graham C. Cervical intervertebral disc protrusion in two horses. Can Vet J 1983; 24 (06) 188-191
  • 34 Furr MO, Anver M, Wise M. Intervertebral disk prolapse and diskospondylitis in a horse. J Am Vet Med Assoc 1991; 198 (12) 2095-2096
  • 35 Fuentealba IC, Weeks BR, Martin MT, Joyce JR, Wease GS. Spinal cord ischemic necrosis due to fibrocartilaginous embolism in a horse. J Vet Diagn Invest 1991; 3 (02) 176-179