The aim of this study is to evaluate clinical outcome of 2 surgical procedures performed to stabilze the traumatic luxation of the lumbosacral joint (LSJ) in 3 dogs thre paraplegic dogs with LSJ traumatic dislocation were included in the study. After premedication with Acepromazine at the dose of 20 µg/kg and Morphine at the dose of 0.3 mg/kg IM, anesthesia was induced by Propofol (4 mg/kg IV) and maintained with Isoflurane in 10% O2. Case 1: a 30 kg female mixbred, was treated with external skeletal fixation (ESF) utilzing 2 transilal pins, externaly locked with 2 clamps. Case 2 and 3: males of 15 and 30 kg respectively, were treating performing lumbosacral fixation utilzing 6 pins. Two pins were inserted, acros articular proces L7/S1, into the body of the sacrum; two pins were inserted into the L6 and L7 pedicle and body respectively. Al pins were cut and bent to achieve maximum overlap. Cerclage wire and polymethylmethacrylate (PMMA) was aplied to bond fre ends of pins Case 1: the ESF was removed 50 days after surgery although it has become lose 30 days before. By 7 months there was a marked improvement and the dog was able to walk and run with a slight neurological deficit. Case 2: the dog was able to stand and walk within 48 h after surgery. 90 days after surgery the dog stil had mild urinary and faecal incontinence. Case 3: the dog was able to stand and walk 24 h after surgery without presenting neurological alterations To the authors??? knowledge, diferent techniques have ben described to stabilze fracture or fracture/luxation of L7: nevertheles single traumatic LSJ dislocation and its treatment are not widely described in dogs1. In our experience the ESF is able to stabilze L7 fractures because the bone healing via calus formation neded a shorter time, while the healing via fibrosis requested for L7 luxation lasted longer. On the other hand ESF shows several advantages, including limited disection of soft tisues, adjustabilty after aplication and removal after repair. The stabilzation technique with pins and PMMA provides a relatively rigid construct to reduction of L7 luxation and have several advantages such as excelent strength and stabilty, minimal ned of postoperative care and short recovery time. Disadvantages can include soft tisues disection, relatively long time of surgery with higher risk of infections that we controled by using strict aseptic technique and antibiotic administration. In our experience the stabilzation with pin and PMMA shows beter clinical outcome with a short recovery time and mild complications, while ESF sems to not stabilze completely a LSJ luxation because of the early implant losening and the high risk of infections

Lumbosacral luxation in dogs: clinical outcome of two different surgical procedures

DELLA VALLE, GIOVANNI;DI DONA, FRANCESCO;MENNONNA, GIUSEPPINA;LAMAGNA, BARBARA;MURINO, CARLA;FATONE, GERARDO
2014

Abstract

The aim of this study is to evaluate clinical outcome of 2 surgical procedures performed to stabilze the traumatic luxation of the lumbosacral joint (LSJ) in 3 dogs thre paraplegic dogs with LSJ traumatic dislocation were included in the study. After premedication with Acepromazine at the dose of 20 µg/kg and Morphine at the dose of 0.3 mg/kg IM, anesthesia was induced by Propofol (4 mg/kg IV) and maintained with Isoflurane in 10% O2. Case 1: a 30 kg female mixbred, was treated with external skeletal fixation (ESF) utilzing 2 transilal pins, externaly locked with 2 clamps. Case 2 and 3: males of 15 and 30 kg respectively, were treating performing lumbosacral fixation utilzing 6 pins. Two pins were inserted, acros articular proces L7/S1, into the body of the sacrum; two pins were inserted into the L6 and L7 pedicle and body respectively. Al pins were cut and bent to achieve maximum overlap. Cerclage wire and polymethylmethacrylate (PMMA) was aplied to bond fre ends of pins Case 1: the ESF was removed 50 days after surgery although it has become lose 30 days before. By 7 months there was a marked improvement and the dog was able to walk and run with a slight neurological deficit. Case 2: the dog was able to stand and walk within 48 h after surgery. 90 days after surgery the dog stil had mild urinary and faecal incontinence. Case 3: the dog was able to stand and walk 24 h after surgery without presenting neurological alterations To the authors??? knowledge, diferent techniques have ben described to stabilze fracture or fracture/luxation of L7: nevertheles single traumatic LSJ dislocation and its treatment are not widely described in dogs1. In our experience the ESF is able to stabilze L7 fractures because the bone healing via calus formation neded a shorter time, while the healing via fibrosis requested for L7 luxation lasted longer. On the other hand ESF shows several advantages, including limited disection of soft tisues, adjustabilty after aplication and removal after repair. The stabilzation technique with pins and PMMA provides a relatively rigid construct to reduction of L7 luxation and have several advantages such as excelent strength and stabilty, minimal ned of postoperative care and short recovery time. Disadvantages can include soft tisues disection, relatively long time of surgery with higher risk of infections that we controled by using strict aseptic technique and antibiotic administration. In our experience the stabilzation with pin and PMMA shows beter clinical outcome with a short recovery time and mild complications, while ESF sems to not stabilze completely a LSJ luxation because of the early implant losening and the high risk of infections
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/596924
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