Abstract

AbstractThis study aimed to assess the long-term outcome and intervertebral fusion following surgical distraction and stabilization using an intervertebral cage and pedicle screw and rod fixation (PSRF) in a dog with severe degenerative lumbosacral stenosis (DLSS).Degenerative lumbosacral stenosis is a common disorder in large breed dogs and has a multifactorial origin. Surgical treatment by dorsal laminectomy and discectomy results in decompression of neural structures, but when distraction–fixation is applied, the ultimate goal is vertebral fusion. A 4-year-old male neutered Leonberger, presented with DLSS and pre-existent chronic discospondylitis, was treated by dorsal laminectomy, partial discectomy, curettage of the end plates, distraction with an intervertebral spacer (SynCage), and PSRF. At 26 months after surgery, the Helsinki pain score and neurological Griffith score were improved; however, the dog passed away shortly thereafter due to an unrelated disorder. The lumbosacral segment became available for computed tomography (CT), micro-CT and histopathology. On CT, bone volume through the largest hole of the cage was 91.0% and for compact bone 76.1%. Micro-CT and histopathology revealed vertebral fusion. Distraction–fixation using an intervertebral spacer and PSRF was well-accepted in this dog with severe DLSS, and the dog had a good clinical outcome with long-term follow-up. CT, micro-CT and histopathology showed evidence of vertebral fusion.

Highlights

  • Degenerative lumbosacral stenosis is a multifactorial degenerative disorder characterized by intervertebral disc degeneration/herniation and bony and soft tissue proliferations that contribute to spinal stenosis and cauda equina compression leading to pain, lameness and neurological signs.[3]

  • When pedicle screw and rod fixation (PSRF) is combined with distraction, it restores the intervertebral disc and foraminal width which is beneficial in case of severe Degenerative lumbosacral stenosis (DLSS) and foraminal stenosis.[9,10]

  • This case study showed that distraction–fixation using an intervertebral cage and PSRF resulted in good clinical outcome for low back pain in a dog with severe DLSS

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Summary

Introduction

Degenerative lumbosacral stenosis (DLSS) is a common syndrome affecting mainly large breed dogs.[1,2] Degenerative lumbosacral stenosis is a multifactorial degenerative disorder characterized by intervertebral disc degeneration/herniation and bony and soft tissue proliferations that contribute to spinal stenosis and cauda equina compression leading to pain, lameness and neurological signs.[3] Clinical suspicion of DLSS based on low back pain and findings on neurological examination is confirmed by findings on computed tomography (CT) and magnetic resonance imaging (MRI), with MRI giving the most detailed information on bony and soft tissue changes. Outcome was assessed during long-term follow-up, and vertebral fusion was examined using radiography, CT, micro-CT and histopathology

Case Description
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