History
- A 6 years old baladi dog was presented after a car accident with acute onset hind limbs paraplegia with severe vocalization. The animal was alert. It was suspected to have vertebral fracture.
- Direct instruction to minimize manipulation and handling with keeping on the lateral recumbency position till excluding a vertebral fracture with x. Ray.
Neurological examination revealed
1. Preserved withdrawal reflex of both hind limbs (HL).
2. Regional nerve examination revealed intact peroneal, tibial and sciatic nerve.
3. Weak deep pain sensation of both hind limbs.
4. Exaggerated patellar reflex with right limb has colonus extension
5. Preserved anal and peroneal reflexes.
6. Panniculus reflex; No dermtomal superficial sensation caudal to T7
7.urinary incontinence.
8. The dog was paralyzed so, proprioception evaluation has no significance.
Suspected neurological deficit site
- Affected mid back T4-L4 spinal segment with UMN deficits (upper motor neuron UMN deficits).
With X.ray & MRI
- vertebral column luxation T13-L2 with fractured and separated ventral L1 buttress. MRI has confirmed the diagnosis with additional further L1 telescoping and transection of spinal cord up to 75% of its core volume.
Decision
- Vertebral fusion within 48 hours of onset of signs
Surgical technique (s)
- Dorsal fusion, modified segmental fixation with additional screws and PMMA cement placement.
Expectations
- not more than 50%
Three months after vertebral fusion and Stem cells injection intrathecally:
