Presented in part at the 34th Annual Conference of the Veterinary Orthopedic Society, Sun Valley, ID, March 3–10, 2007.
Original Article - Clinical
Reduction and Fixation of Cranial Cervical Fracture/Luxations using Screws and Polymethylmethacrylate (PMMA) Cement: A Distraction Technique Applied to the Base of the Skull in Thirteen Dogs
Article first published online: 20 DEC 2011
© Copyright 2011 by The American College of Veterinary Surgeons
Volume 41, Issue 2, pages 235–247, February 2012
How to Cite
Pike, F. S., Kumar, M. S. A. and Boudrieau, R. J. (2012), Reduction and Fixation of Cranial Cervical Fracture/Luxations using Screws and Polymethylmethacrylate (PMMA) Cement: A Distraction Technique Applied to the Base of the Skull in Thirteen Dogs. Veterinary Surgery, 41: 235–247. doi: 10.1111/j.1532-950X.2011.00916.x
- Issue published online: 16 FEB 2012
- Article first published online: 20 DEC 2011
- Manuscript Accepted: SEP 2011
- Manuscript Received: AUG 2010
To (1) describe a surgical distraction technique for C1-2 cervical fractures/luxations or atlantoaxial (AA) subluxations using the base of the skull (basion of the foramen magnum) and either C2-3 or C3-4 for the purchase points of intraoperative axial distraction and (2) report outcome in 13 dogs.
Retrospective case series.
Dogs (n = 13).
Materials and Methods
Medical records (September 1995–December 2005) of dogs with fracture/luxation of the cervical spine, or AA subluxations, were reviewed. Only dogs that had intraoperative linear distraction using the base of the skull as a purchase point for a self-retaining retractor were included. Signalment, presenting neurologic deficits, fracture location, and concurrent injury were recorded. Both short-term in-hospital follow-up, including healing and any complications, and long-term telephone follow-up were obtained.
Realignment of the spinal vertebrae, reestablishing the normal properties of the spinal canal, was achieved after distraction in all dogs. Screws and small pins incorporated into polymethylmethacrylate cement were used to span the fracture ventrally and achieve rigid internal fixation. Eight dogs had a complete neurologic recovery, 2 dogs had slight residual ataxia, 2 dogs died, and 1 dog was lost to follow-up. Healing was good (mean, 7.5 weeks) or excellent (mean, 5.1 months) based on in-hospital follow-up (mean, 5.1 months). On final telephone follow-up (mean, 7.7 years), no dogs were reported to have had any associated problems or additional surgery.
This surgical distraction technique was a reliable, relatively simple method to obtain reduction of fracture/luxations of C1-2 to re-align the spinal canal. Mortality in this series appears lower than that previously reported and supports surgical management of these injuries.