Keywords
How to Cite
Abstract
This work aims to report the use of computed tomography (CT) and 3D printing technology in the diagnosis of dynamic instability with spinal compression, and the planning of cervical stabilization surgical of a 3-month-old canine with congenital cervical malformations. The patient had non-ambulatory tetraparesis, and a radiograph showed the fusion of the vertebral bodies from C3 to T3. A CT scan pinpointed the site of the spinal compression and revealed dynamic instability and severe spinal compression between the C2-C3 vertebrae. Tomographic images were processed to print a 3D prosthesis of the patient’s craniocervical-thoracic region to optimize and plan the necessary surgery. After studying the 3D prosthesis and selecting the surgical implants required, cervical stabilization surgery through ventral access was performed. The patient’s clinical improvement was rapid and progressive. Fifteen days post-surgery he was already in a quadrupedal position, after approximately 50 days he started walking again. In a year and a half of follow-up, the patient did not present any recurrence of the clinical signs. The conclusion was that CT and 3D printing contributed substancially for the clinical and surgical management, inferring quality, precision, and agility in the therapy undertaken.
References
Bailey, C. S., & Morgan, J. P. (1992). Congenital Spinal Malformations. The Veterinary Clinics of North America. Small Animal Practice, 22(4), 985-1015. http://dx.doi.org/10.1016/S0195-5616(92)50089-4. PMid:1641930.
Beaver, D. P., Ellison, G. W., Lewis, D. D., Goring, R. L., Kubilis, P. S., & Barchard, C. (2000). Risk factors affecting the outcome of surgery for atlantoaxial subluxation in dogs: 46 cases (1978-1998). Journal of the American Veterinary Medical Association, 216(7), 1104-1109. http://dx.doi.org/10.2460/javma.2000.216.1104. PMid:10754672.
Burkholder, W. J., & Toll, P. W. (2000). Obesity. In Hand, M.S.; Tatcher, C.D. & Remillard, R.L. Small Animal Clinical Nutrition (4th ed., pp. 401-430). Kansas: Mark Morris institute.
De Rycke, L. & Saunders, J. H. (2017). Congenital anomalies of the vertebrae in dogs. Vlaams Diergeneeskundig Tijdschrift, 86(2), 105-118. http://dx.doi.org/10.21825/vdt.v86i2.16296
Du, Y. Q., Qiao, G. Y., Yin, Y. H., Li, T., Tong, H. Y., & Yu, X. G (2020). Usefulness of 3D printed models in the management of complex craniovertebral junction anomalies: Choices of treatment strategy, design of screw trajectory, and protection of vertebral artery. World Neurosurgery Journal, 133, 722-729. http://dx.doi. org/10.1016/j.wneu.2019.09.139. PMid:31589981.
Fernandes, R., Fitzpatrick, N., Rusbridge, C., Rose, J., & Driver, C. J. (2019). Cervical vertebral malformations in nine dogs: Radiological findings, treatment options and outcomes. Irish Veterinary Journal, 72(2), 1-13. http:// dx.doi.org/10.1186/s13620-019-0141-9. PMid:31044069.
Forterre, F., Vizcaino Reve, N., Stahl, C., Gendron, K., & Spreng, D. (2012). An indirect reduction technique for ventral stabilization of atlantoxial instability in miniature breed dogs. Veterinary and Comparative Orthopaedics and Traumatology, 25(4), 332-336. http://dx.doi.org/10.3415/VCOT-11-07-0107. PMid:22580918.
Grosso, M. J., Hwang, R., Krishnaney, A. A., Mroz, T. E., Benzel, E. C., & Steinmetz, M. P. (2015). Complications and outcomes for surgical approaches to cervical kyphosis. Journal of Spinal Disorders & Techniques, 28(7), 385-393. http://dx.doi.org/10.1097/BSD.0b013e318299953f. PMid:23732179.
Ishikawa, Y., Kanemura, T., Yoshida, G., Matsumoto, A., Ito, Z., Tauchi, R., Muramoto, A., Ohno, S., & Nishimura, Y. (2011). Intraoperative, fullrotation, three-dimensional image (O-arm)-based navigation system for cervical pedicle screw insertion. Journal of Neurosurgery. Spine, 15(5), 472-478. http://dx.doi.org/10.3171/2011.6.SPINE10809. PMid:21761967.
Kamishina, H., Sugawara, T., Nakata, K., Nishida, H., Yada, N., Fujioka, T., Nagata, Y., Doi, A., Konno, N., Uchida, F., & Maeda, S. (2019). Clinical aplication of 3D printing technology to the surgical treatment of atlantoaxial subluxation in small breed dogs. PLoS One, 14(5), 1-18. http://dx.doi.org/10.1371/journal.pone.0216445. PMid:31050689.
Kaplan, K. M., Spivak, J. M., & Bendo, J. A. (2004). Embryology of the spine and associated congenital abnormalities. The Spine Journal, 5(5), 564-576. http://dx.doi.org/10.1016/j.spinee.2004.10.044. PMid:16153587.
Kawakami, N., Tsuji, T., Imagama, S., Lenke, L. G., Puno, R. M., & Kuklo, T. R. (2009). Classification of congenital scoliosis and kyphosis: A new approach to the three-dimensional classification for progressive vertebral anomalies requiring operative treatment. The Spine Journal, 34(17), 1756-1765. http://dx.doi.org/10.1097/ BRS.0b013e3181ac0045. PMid:19644327.
Sanders, S. G., Bagley, R. S., Silver, G. M., Moore, M., & Tucker, R. L. (2004). Outcomes and complications associated with ventral screws, pins, and polymethyl methacrylate for atlantoaxial instability in 12 dogs. Journal of the American Animal Hospital Association, 40(3), 204-210. http://dx.doi.org/10.5326/0400204. PMid:15131100.
Lorigados, C. A. B., & Pinto, A. C. B. F. (2013). Tomografia computadorizada do encéfalo do cão: Aspectos da normalidade e correlação anatômica. Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 65(3), 729-734. http://dx.doi.org/10.1590/S0102-09352013000300018.
Schulz, K. S., Waldron, D. R., & Fahie, M. (1997). Application of ventral pins and polymethylmethacrylate for the management of atlantoaxial instability: Results in nine dogs. Veterinary Surgery, 26(4), 317-325. http://dx.doi. org/10.1111/j.1532-950X.1997.tb01504.x. PMid:9232790.
Westworth, D. R., & Sturges, B. K. (2016). Congenital Spinal Malformations in Small Animals. The Veterinary Clinics of North America. Small Animal Practice, 40(5), 951-981. http://dx.doi.org/10.1016/j.cvsm.2010.05.009. PMid:20732600.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Maria Eduarda dos Santos Lopes Fernandes, Ricardo Siqueira da Silva, Leonardo Rodrigues de Lima, Lucas Rego Ramos, Anna Julia Rodrigues Peixoto, Gabriela Wacheleski Brock, José Eduardo Silveira Coutinho, Eveliny de Oliveira Eleuterio, Alex Gradowski Adeodato, Cássia Maria Molinaro Coelho