Canine Seventh Lumbar Vertebra Fracture: A Systematic Review

Simple Summary

The aim of this paper is to review the available literature about canine seventh vertebra lumbar fracture. According to PRISMA guidelines, the authors detected data about the clinical presentation, surgical techniques, and the outcome of this rare traumatic injury that is poorly reported and described. The major problem addressed was the lack of prospective studies with a large study population and univocal data collection about complications, outcome, and post-surgical treatment.

Abstract

(1) Background: Lumbosacral traumatic injuries are reported as 39% of canine vertebral lesions. This area is prone to fracture and luxation. Several surgical techniques were described from 1975 to 2021 to stabilize the traumatic injuries of the lumbosacral junction. This report aims to critically review the available literature focused on clinical presentation, surgical techniques, and follow-up of the lumbar vertebra fracture. (2) Methods: Three bibliographic databases: PubMed, Google Scholar, and Scopus were used with a board search of Lumbosacral junction fracture AND, of L7 fracture AND (canine OR dog). The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for case reports and case series was applied for the studies included. (3) Results: A total of 432 reports yielded only nine that met the inclusion criteria. Non-ambulatory paraparesis/plegia, sciatic nerve involvement, faecal/urinary incontinence, and severe back lumbar pain were the most reported signs. Survey radiographs were the most reported technique to confirm the diagnoses. The surgical treatment was reported in all reports examined with a good long-term prognosis. (4) Conclusions: The seventh lumbar vertebra fracture, despite the different surgical techniques performed, had a favourable prognosis for long-term outcome and neurological recovery.

Pedicle screws implantation in polymethylmethacrylate construct to stabilise sixth lumbar vertebral body fracture in dogs: 5 cases (2015-2018)

OBJECTIVES

To assess the feasibility and outcome of pedicle screw implantation on sixth lumbar vertebral body fractures.

MATERIALS AND METHODS

Dogs with sixth lumbar vertebral body fractures stabilised using L6 and L7 (±L5) pedicular implantation via a dorsal approach preferentially and conventional vertebral body implantation otherwise were reviewed. Coaptation was made with bone cement. Complete neurological examination, pre and postoperative imaging consistent with L6 body fracture (radiographs ± CT scan) and follow up including clinical examination and radiographs 3 to 5 weeks post-operatively were required as inclusion criteria. When available, owner interview and/or clinical examination and imaging (radiographs ± CT scan) at least 1 year after surgery were reported.

RESULTS

Five dogs met the inclusion criteria. Dorsal pedicle screws implantation was feasible in all L7 vertebrae and in four L6 vertebrae. Adequate implantation was observed in all of the post-operative radiographs and on all of the three CT scans available. At 3 to 6 weeks after surgery, neurological status and locomotion were normal in four dogs, while one dog suffering from severe sciatic neuropathy did not regain normal locomotion. At least 1 year after surgery, clinical outcome was excellent for four dogs and imaging by radiography and CT scan were available for three dogs and showed complete healing of the fracture and correct positioning of the implants. The dog suffering from sciatic neuropathy had a further trauma and was euthanased 7 weeks after the surgery.

CLINICAL SIGNIFICANCE

In this case series, pedicle screw implantation achieved stabilisation of L6 vertebral body fractures, with full recovery observed in four out of five dogs. Further studies are required to confirm the safety and the effectiveness of this intervention.