Abstract
Few biomechanical studies have evaluated the effect of internal stabilization techniques after decompressive surgery on the stability of the canine lumbosacral junction. The purpose of this canine cadaver study is to evaluate the stability of the canine lumbosacral (LS) spine in flexion and extension following laminectomy and discectomy and then stabilization with each of the three techniques: pins and polymethylmethacrylate (P/PMMA), two dorsal locking plates (SOP) or bilateral transarticular facet screws (FACET).Using a cantilever biomechanical system, bending moments were applied to the LS and range of motion (ROM) was recorded via a rotational potentiometer. With 3 Nm, the ROM (n = 4 in each group) for P/PMMA, SOP and FACET were 1.92 ± 0.96°, 2.56 ± 0.55°and 3.18 ± 1.14°, respectively. With moments up to 35 Nm, the P/PMMA specimens appeared stable. Sacroiliac motion in the SOP and FACET groups invalidated further comparisons. Each of the stabilization techniques (P/PMMA, SOP, and FACET) significantly decreased the range of motion in flexion and extension for low bending moments.
Highlights
Degenerative Lumbosacral Stenosis (DLS) is a common cause of caudal lumbar pain, difficulty in sitting and difficulty rising in middle aged large breed dogs (Meij & Bergknut, 2010)
In the pins and polymethylmethacrylate (P/PMMA) group, testing was stopped at 35 Nm of bending for three specimens, with no implant failure noted on gross inspection, or on radiographs
This study demonstrates that the LS region had much less range of motion after stabilization with each fixation technique, but, because the P/PMMA technique bridges the SI joint, and the facet screws (FACET) and SOP techniques did not, the specimens moved very differently during testing at higher bending moments
Summary
Degenerative Lumbosacral Stenosis (DLS) is a common cause of caudal lumbar pain, difficulty in sitting and difficulty rising in middle aged large breed dogs (Meij & Bergknut, 2010). It is thought that increased motion at the lumbosacral junction is the most important contributor to the degenerative changes and progression of clinical signs in dogs (Meij & Bergknut, 2010). Surgical management is recommended for patients with severe or recurrent pain that is not responsive to medical management or when neurologic deficits are present (Johnston & Tobias, 2012a). Common surgical options for DLS include dorsal laminectomy alone or in combination with a partial discectomy, dorsal laminectomy combined with fixation and fusion or lateral foraminotomy (Meij et al, 2007; Hankin et al, 2012; Smolders et al, 2012a; Smolders et al, 2012b).
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