Vertebral Fusion of T11-T12 vertebral fracture

History

A 33 kg female baladi mixed dog was presented to our clinic in Cairo “DrPaws Veterinary Hospital” with history of car accident one day before presentation sudden loss of hind limbs voluntary movement “Paralysis”. The dog had urine retention.
Vertebral fracture was suspected and radiographic examination was performed which confirmed a T11-T12 vertebral luxation with T11 proximal end telescoping into the vertebral canal.

Neurological Examination

Exaggerated hind limb reflexes; Patellar reflex, Coxofemoral reflex and Cranial tibial reflex (+3)
Normal Withdrawal reflex (+2)
Weak deep pain sensation (1) of both hind limbs
intact perineal reflex (+3)
Panniculus reflex revealed no dermatomal sensation caudal to level of T13 vertebrae.
Normal forelimbs reflexes.
Normal cranial nerves examination (+2) including Menace reflex, PLR, PL with no nystagmus or strabismus.
Dog was reported to have normal swallowing reflexes before accident (Normal GAG reflex) (+2)
Dog had Grade “5” neurological deficits with less than 5% success rates of conservative treatment and increased (up to 50%) improvement chances with direct surgical interference.

Recommendations

Computed Tomography

T11-T12 vertebral fracture with telescoping of the caudal proximal T11 fragment into the vertebral canal. The ventral buttress of T11 was found to be slightly separated from the rest of the vertebrae at the T11-T12 junction.

Decision

Steps of Surgery

Approach: epiaxial vertebral approach at the both sides of vertebral dorsal processes.
Vertebral fusion and Fixation was performed by the use of 4 screws and 6 K. wires followed by fusion by PMMA cement substance.