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Piao Z, Kim YU, Ko J, Lee J, Choi D, Kim N. Evaluation of Safe Insertion Angles for Spinal Needles and Safe Intensity of the Holmium:YAG Laser during Percutaneous Laser Disc Ablations in Feline Cadavers. Vet Sci 2024; 11:325. [PMID: 39058009 PMCID: PMC11281609 DOI: 10.3390/vetsci11070325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/29/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
In the context of veterinary medicine, minimally invasive techniques for feline spinal surgery remain underexplored, particularly for percutaneous laser disc ablation (PLDA) when using the Holmium:YAG (Ho:YAG) laser. This study aimed to refine the application of the Ho:YAG laser in PLDA by determining the optimal laser intensity and safe insertion angles for the thoracic and lumbar intervertebral discs (IVDs) in cats. Through utilizing computed tomography (CT) for precise guidance, this research involved a cadaveric study of 10 cats to evaluate the spatial configurations that allow for safe needle insertions and effective laser ablation. Various energy settings of the Ho:YAG laser (20 J, 40 J, and 60 J) were tested to ascertain the balance between adequate disc vaporization and minimal adjacent tissue damage. The results demonstrate that a 40 J setting is the most effective in achieving significant disc decompression without compromising surrounding tissue integrity. Additionally, the CT scans proved crucial in confirming the accuracy of the needle placement and the safety of the laser application angles. This study established that the 40 J setting on the Ho:YAG laser, combined with CT-guided insertion techniques, offers a reliable method for PLDA, thus enhancing the safety and efficacy of feline spinal surgeries.
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Affiliation(s)
- Zhenglin Piao
- Department of Veterinary Medicine, College of Agriculture, Yanbian University, Yanji 133002, China;
| | - Young-ung Kim
- Yeon Animal Medical Center, Seoul 07700, Republic of Korea;
| | - Jongchan Ko
- Department of Veterinary Surgery, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (J.K.); (J.L.); (D.C.)
| | - Jumjae Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (J.K.); (J.L.); (D.C.)
| | - Daeyoung Choi
- Department of Veterinary Surgery, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (J.K.); (J.L.); (D.C.)
| | - Namsoo Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (J.K.); (J.L.); (D.C.)
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Kim KB, Jeong JM, Jeon YJ, Jeong SM, Kim DH, Lee HB. C1 Facetectomy and Ventral Fixation of Occipitoatlantoaxial Complex for Concurrent Congenital Atlanto-Occipital Dislocation and Atlantoaxial Instability in a Toy Poodle. Animals (Basel) 2024; 14:1886. [PMID: 38997998 PMCID: PMC11240570 DOI: 10.3390/ani14131886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/15/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
An 8-month-old, 3.4 kg, castrated male Toy Poodle was referred for progressive tetraparesis and respiratory disorder without a history of trauma. Repeated computed tomography (CT) and magnetic resonance imaging (MRI) with different positions of the neck revealed concurrent atlanto-occipital dislocation (AOD) and atlantoaxial instability (AAI) with spinal cord compression. This case was unique due to its congenital nature and the absence of trauma. The surgical treatment involved precise removal of the C1 vertebra's ventral articular facet, which was compressing on the spinal cord, attributed to its fixed and malaligned position within the atlantooccipital joint. Following facetectomy, the stabilization of the occipital bone to the C2 vertebra was achieved by screws, wire, and polymethyl methacrylate. Two days after surgery, the dog recovered ambulation and showed gradual improvement in gait, despite mild residual ataxia. Postoperative CT and radiographs showed successful decompression of the spinal cord. The screw loosening was confirmed at 114 days, which was managed successfully by extracting the affected screws. Through the 21-month monitoring period, the dog showed a normal gait with a wide-based stance of the pelvic limbs when standing and experienced no pain. This case represents the first report of concurrent congenital AOD and AAI treated with a ventral surgical approach, contributing new insights to the understanding and management of such complex cranio-cervical junction disorders in veterinary neurosurgery.
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Affiliation(s)
| | | | | | | | | | - Hae-Beom Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99, Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea; (K.-B.K.); (J.-M.J.); (Y.-J.J.); (S.-M.J.); (D.-H.K.)
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Yu Y, Kang J, Kim N, Heo S. Accuracy of a patient-specific 3D-printed drill guide for placement of bicortical screws in atlantoaxial ventral stabilization in dogs. PLoS One 2022; 17:e0272336. [PMID: 35913954 PMCID: PMC9342780 DOI: 10.1371/journal.pone.0272336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
Atlantoaxial instability (AAI) in dogs refers to abnormal motion at the C1–C2 articulation due to congenital or developmental anomalies. Surgical treatment options for AAI include dorsal and ventral stabilization techniques. Ventral stabilization techniques commonly utilize transarticular and vertebral body screws or pins. However, accurate screw insertion into the vertebrae of C1 and C2 is difficult because of the narrow safety corridors. This study included 10 mixed dogs, 1 Pomeranian, and 1 Shih-Tzu cadaver. All dogs weighed <10 kg. Each specimen was scanned using computed tomography (CT) from the head to the 7th cervical vertebrae. This study used 12 bone models and 6 patient-specific drill guides. Bone models were made using CT images and drill guides were created through a CAD (computer-aided design) program. A total of six cortical screws were used for each specimen. Two screws were placed at each of the C1, C2 cranial, and C2 caudal positions. Postoperative CT images of the cervical region were obtained. The degree of cortex breaching and angle and bicortical status of each screw was evaluated. The number of screws that did not penetrate the vertebral canal was higher in the guided group (33/36, 92%) than in the control group (20/36, 56%) (P = 0.003). The screw angles were more similar to the reference angle compared to the control group. The number of bicortically applied screws in the control group was 28/36 (78%) compared to 34/36 (94%) in the guided group. Differences between the preoperative plan and the length of the applied screw at the C1 and C2 caudal positions were determined by comparing the screw lengths in the guide group. The study results demonstrated that the use of a patient-specific 3D-printed drill guide for AAI ventral stabilization can improve the accuracy of the surgery. The use of rehearsal using bone models and a drilling guide may improve screw insertion accuracy.
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Affiliation(s)
- Yong Yu
- Department of Veterinary Surgery, Jeonbuk National University, Gobong-ro, Iksan, South Korea
| | - Jinsu Kang
- Department of Veterinary Surgery, Jeonbuk National University, Gobong-ro, Iksan, South Korea
| | - Namsoo Kim
- Department of Veterinary Surgery, Jeonbuk National University, Gobong-ro, Iksan, South Korea
| | - Suyoung Heo
- Department of Veterinary Surgery, Jeonbuk National University, Gobong-ro, Iksan, South Korea
- * E-mail:
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Roh Y, Kim D, Jeong S, Lee H. Evaluation of the accuracy of three-dimensionally printed patient-specific guides for transsphenoidal hypophysectomy in small-breed dogs. Am J Vet Res 2022; 83:465-472. [PMID: 35175933 DOI: 10.2460/ajvr.21.09.0154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the accuracy of transsphenoidal hypophysectomy using 3-D printed patient-specific guides (3D-PSGs) in small-breed dogs. ANIMALS Heads obtained from the cadavers of 19 small-breed dogs (ex vivo portion of study) and 3 healthy adult (3 to 4 years) purpose-bred Beagles with a median body weight of 9.2 kg. PROCEDURES In the ex vivo study, CT images of the cadavers were collected. The position, width, and length of the pituitary fossa and the pilot hole (insertion angle and place) were measured. Using PSGs, 19 pilot holes were made for the pituitary gland fossa, and CT was performed to assess the position accuracy. In the in vivo study, 3 surgical windows from the pilot holes were made using PSGs. Repeated CT and MRI were performed to evaluate the safeness and effectiveness of PSGs, followed by necropsy. RESULTS In the ex vivo study, the median (interquartile range) difference between the pre- and postoperative insertion angles was 2° (0° to 3.5°) and the median deviation of the pilot hole was 0.46 mm (0 to 1.58 mm). In the in vivo study, the surrounding structures were not damaged, and favorable outcomes were evident in terms of the shape, size, and position of the surgical window. CLINICAL RELEVANCE 3D-PSGs provided a safe and effective surgical window for transsphenoidal hypophysectomy. Our findings emphasized the applicability of PSGs in brain surgery, in terms of accuracy and effectiveness.
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Gutiérrez A, Ezquerra LJ, Rodríguez PL, Jiménez J. Cardiac Radiographic Measurements in Ferrets Using the OsiriX MD Programme. Front Vet Sci 2022; 8:795947. [PMID: 35083307 PMCID: PMC8785872 DOI: 10.3389/fvets.2021.795947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022] Open
Abstract
Objectives: To adapt the vertebral heart scale (VHS) for use in ferrets and identify new scales and tools that allow to establish the normal heart size by means of radiography more quickly and effectively. Methods: Forty healthy pet ferrets (Mustela putorius furo) were used in this prospective study. The measurements were made on right lateral, left lateral, ventrodorsal, and dorsoventral projections, using OsiriX MD medical imaging software, to evaluate sex effect and variance within the different heart scales. Cardiac measurements were also correlated to VHS and the cardiac dimension in the same projection. Results: Most of the cardiac measurements were significantly different between males and females. The results for the VHS were: right lateral VHS (RL-VHS): 5.52 ± 0.28 v (vertebrae units); left lateral (LL-VHS): 5.55 ± 0.28 v; and dorsoventral VHS (DV-VHS): 6.22 ± 0.34 v for males and RL-VHS: 5.24 ± 0.2 v; LL-VHS: 5.25 ± 0.20 v; and DV-VHS: 5.97 ± 0.35 v for females. Regarding the sternebral heart scale (SHS), the values were: RL-SHS: 5.10 ± 0.20 s (sternebrae units) and LL-SHS: 5.11 ± 0.20 s for males and RL-SHS: 4.67 ± 0.24 s and LL-SHS: 4.67 ± 0.28 s for females. The new measurements based on determining the cardiac area were also marked by clear sexual dimorphism, as shown for the cardiac area-axis (AREA-AXIS): RL-AREA-AXIS: 3.82 ± 0.45 cm2; LL-AREA-AXIS: 3.87 ± 0.41 cm2; ventrodorsal (VD)-AREA-AXIS: 4.59 ± 0.64 cm2; and DV-AREA-AXIS: 4.80 ± 0.50 cm2 for males and RL-AREA-AXIS: 2.39 ± 0.23 cm2; LL-AREA-AXIS: 2.41 ± 0.26 cm2; VD-AREA-AXIS: 3.08 ± 0.45 cm2; and DV-AREA-AXIS: 3.06 ± 0.47 cm2 for females. The cardiac area open polygon (AREA-POL) values were: RL-AREA-POL: 6.78 ± 0.65 cm2; LL-AREA-POL: 6.88 ± 0.68 cm2; VD-AREA-POL: 7.20 ± 0.91 cm2; and DV-AREA-POL: 7.57 ± 0.88 cm2 for males and RL-AREA-POL: 4.28 ± 0.30 cm2; LL-AREA-POL: 4.35 ± 0.35 cm2; VD-AREA-POL: 4.72 ± 0.65 cm2; and DV-AREA-POL: 4.79 ± 0.66 cm2 for females, with similar differences noted from various radiographic projections. A good correlation was noted between VHS and SHS, and a very strongly positive correlation existed between cardiac area measurements and cardiac dimensions. Conclusion: The VHS adapted to ferrets, the SHS, as well as the cardiac area measurements presented in our study are ideal tools for the assessment of cardiac size in ferrets.
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Affiliation(s)
- Alejandro Gutiérrez
- Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, Caceres, Spain
- *Correspondence: Alejandro Gutiérrez
| | - Luis J. Ezquerra
- Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, Caceres, Spain
| | - Pedro L. Rodríguez
- Departamento de Produccion Animal y Ciencia de los Alimentos, Universidad de Extremadura, Caceres, Spain
| | - Joaquín Jiménez
- Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, Caceres, Spain
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Hansen SC, Bacek LM, Kuo KW, Taylor AR. Traumatic atlantoaxial subluxation in dogs: 8 cases (2009-2016). J Vet Emerg Crit Care (San Antonio) 2019; 29:301-308. [PMID: 31025805 DOI: 10.1111/vec.12835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/26/2017] [Accepted: 05/03/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To demonstrate the utility of advanced imaging in dogs with traumatic atlantoaxial subluxation (TAAS), and to report the presentation, treatment, and outcome for these dogs. DESIGN Retrospective study (2009-2016). SETTING University teaching hospital. ANIMALS Eight dogs diagnosed with TAAS with magnetic resonance imaging (MRI), computed tomography (CT), or both. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Eight dogs met criteria for inclusion. Of these, 6 were male, median age was 4 years (range, 1.5-11 years), and median body weight was 4.9 kg (range, 3.0-25.0 kg). On presentation, 6/8 (75%) dogs were nonambulatory tetraparetic and the most common injury was trauma inflicted by another animal 5/8 (62.5%). Diagnosis of TAAS was made using a combination of imaging modalities including vertebral column radiographs in 7/8 (87.5%) (of which 71.4% were suspicious for TAAS), CT in 7/8 (87.5%), and MRI in 7/8 (87.5%). In 7/8 (87.5%) dogs, CT and/or MRI offered additional information regarding the extent of injuries. Vertebral fractures were identified in 62.5% (5/8) of dogs. The majority of dogs underwent surgical repair (7/8 [87.5%]). The most common complication was aspiration pneumonia (3/8 [37.5%]). All 8 dogs survived to discharge. At the time of discharge, 4/8 (50%) were ambulatory tetraparetic. The 4 dogs that were nonambulatory tetraparetic at discharge progressed to being ambulatory within 2 months of surgery. CONCLUSIONS Although TAAS is an uncommon occurrence it should be considered a differential for any trauma patient that is presenting with signs of a cranial cervical myelopathy. CT and MRI have been shown to be useful to identify the extent of injuries and to facilitate surgical planning. With appropriate care, these dogs can have an excellent prognosis.
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Affiliation(s)
- Sonya C Hansen
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL
| | - Lenore M Bacek
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL
| | - Kendon W Kuo
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL
| | - Amanda R Taylor
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL
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Maenohara Y, Matsumoto T, Chang SH, Hirose J, Tanaka S. Guideposts for Inserting Intercuneiform Joint Arthrodesis Screws: Analysis Using Multiplanar Reconstructed Computed Tomography. Foot Ankle Spec 2019; 12:175-180. [PMID: 30484327 DOI: 10.1177/1938640018816373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Intercuneiform arthrodesis is often required for various midfoot pathologies; however, intercuneiform screw insertion is not easy due to the complicated anatomical structure of cuneiforms. This study aimed to determine the advisable screw entry point and direction using intraoperatively detectable landmarks. The computed tomography (CT) scan data of feet were reformatted using OsiriX software multiplanar reconstruction. First, based on the data of 10 CT scans of normal feet, we determined the advisable screw entry point at the upper one-third in the dorsoplantar direction and center in the anteroposterior direction on the medial aspect of the medial cuneiform and insertion direction toward the outermost point of the base of the fifth metatarsal in the axial plane and parallel to the plantar surface in the coronal plane. Second, we examined the accuracy of these newly designed guideposts in the simulation using other CT scan data of the other 27 normal feet and 12 flat feet. The simulated screw trajectory penetrated the mid three-fifths of all three cuneiforms in 97% of the normal feet and 92% of the flat feet with no cases of cortical wall violation. Levels of Evidence: Level V: Expert opinion.
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Affiliation(s)
- Yuji Maenohara
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takumi Matsumoto
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Song Ho Chang
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jun Hirose
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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