History
- A 6 years old dog was presented to our clinic in Cairo (DrPaws Veterinary Hospital) with sudden tetraparesis after a car accident.
Neurological Examination:
- Hyperreflexia or Exaggerated hind limbs reflexes (Patellar, cranial tibial reflex, sciatic reflex) & Fore limbs reflexes (Extensor carpi reflex ECR, triceps, Biceps)
- Normal withdrawal reflex of both hind limbs and fore limbs (+21).
- Normal deep pain sensation (+2)
- UMN deficits of both fore legs and hind limbs
Localization of neurological deficits
- UMN deficits of four limbs (C1-C5)
Radiographic examination: C5-C6 vertebral fracture
Recommendations
- MRI and C.T were performed to evaluate the condition of the spinal cord and severity of injury. C.T was performed to evaluate for preoperative planning of the vertebral fusion.
- Surgical vertebral fusion through a ventral neck approach was recommended
CT & MRI reports shows
- With MRI, most of the spinal cord was kept without transection
- With CT, C5-C6 fracture with fragmentation of the cranial distal part of the C6 and telescoping through the ventral C5 buttress.
Surgical procedures
- Ventral neck approach was the approach of choice for cervical lesions
Precautions and vital structures during dissection are;
- Muscular reflection of brachycephalic muscle, sternocephalic muscle and sternothyrohyoid muscles.
- Trachea, esophagus, recurrent laryngeal nerve, carotid sheath are the main vital structures that should be carefully reflected.
- Vertebral fusion was performed by 4 screws and connecting cerclage wire. Additional bone cement (PMMA) was placed to fix the overall implant.
- CT is crucial for preoperative surgical planning including measuring of screws lengths, entry points, dimensions of the fractured vertebrae.
Postoperative Care;
- Air mattress to decrease occurrence of skin decubitus & Ulcers.
- Wound Care
- Neck brace for 3 weeks
- Physiotherapy & Hydrotherapy
