PMC5026027_01
Operation of cervical spinal cord transection in a dog. C-arm fluoroscopy (a). Exposure of cervical cord (b). PEG application (c). Cervical cord transection using blade (d)
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F1
After the surgical site was sterilized, an incision was made on the skin and the upper trapezius muscle in order to expose the spinous process of the 5th cervical vertebra (C5); the location was confirmed by C-arm fluoroscopy [Figure 1a]. The dorsal part of C5 was removed with a bone rongeur, and the cervical cord was isolated [Figure 1b]. Finally, the surgical site was prepared by applying PEG (PEG MW 400, Sigma-Aldrich, USA) until the cord was submerged [Figure 1c]. Complete transection of the cervical cord was attempted by traversing the same area twice in opposite directions with the blade in contact with the bony floor of C5 [Figure 1d].
Functional recovery over 3 weeks. 72 hours (a), 10 days (b), 14 days (c), 17 days (d), 20 days, and (e) 24 days post-operation (f)
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F2
Tetraplegia continued for 72 hours post-operation [Figure 2a; Video], although response to tickling and deep pain was observed sporadically (MFS: 0~1). After 10 days, the dog had recovered to the point that it was able to balance its torso by moving its forelimbs [Figure 2b; Video]. In 2 weeks, the dog was able to drag its hind limbs by using the forelimbs and torso [Figure 2c; Video]. The dog began to crawl using forelimbs and hind limbs and was able to lift its head and torso halfway through the second week (MFS: 3b) [Figure 2d; Video]. Later during the week, the dog occasionally stood up and was able to support itself on its limb (MFS: 3a) [Figure 2e; Video]. During the third week, function of the limbs considerably recovered to the point that the dog was able to walk without slipping too much and even run occasionally (MFS: 4~5) [Figure 2f; Video].