PMC6151845_01
This image is a dorsal plane STIR MRI of the dog's spine revealing a T2-T3 luxation. Image reveals right lateral displacement of the caudal spine at the level of T2 and T3 vertebrae. The white arrow denotes area of suspected hemorrhage and edema within the spinal canal and spinal cord parenchyma.
CRIVEM2018-9152394.001.jpg
PMC6151845_01_CRIVEM2018-9152394.001.jpg
fig1
Multifocal noncompressive bulges of the C2-C7 intervertebral discs were noted (Figure 1).
(a) Three-dimensional reconstruction of the preoperative computed tomographic imaging. Imaging of the cranial thoracic spine that shows right lateral displacement of the caudal spine at the level of T2 and T3 vertebrae. The white arrow denotes caudal end plate fracture of T2. (b) Preoperative Computer Tomographic imaging of the cranial thoracic spine at the level of the spinal subluxation. The caudal end plate fracture of T2 is noted (white arrow).
CRIVEM2018-9152394.002.jpg
PMC6151845_01_CRIVEM2018-9152394.002.jpg
fig2
T2-T3 (Figure 2). The dog recovered from general anesthesia uneventfully and surgery was scheduled.
Intraoperative image. Black arrows denote sutures of the pericardial sling. White arrows denote Penrose tubing retracting vessels of the brachycephalic trunk.
CRIVEM2018-9152394.003.jpg
PMC6151845_01_CRIVEM2018-9152394.003.jpg
fig3
Similarly, retractors were placed near the thoracic inlet and caudally along the brachycephalic trunk to increase visualization of the spine and prevent vital structures from becoming entrapped with the various power instruments utilized (Figure 3).
Intraoperative image. String-of-Pearls plate (white arrow) placed along ventral spine held in place with a Kirschner wire (black arrow). Grey arrow denotes a drill bit left in place to check depth with fluoroscopy.
CRIVEM2018-9152394.004.jpg
PMC6151845_01_CRIVEM2018-9152394.004.jpg
fig4
An 8-hole 2.0mm String-of-Pearls (SOP) plate (OrthoMed, West Yorkshire, UK) was placed along the ventral aspect of C7-T4 vertebral bodies and temporarily stabilized with 0.89mm Kirschner wires (IMEX Veterinary, Longview, Texas) placed through a node on both sides of the T2-T3 disc space (Figure 4). C7-T3 and placed adjacent to the first plate. 2.0mm cortical screws (DePuy Synthes, West Chester, Pennsylvania) were placed in holes engaging C7, T1, and T3 in the 6-hole plate (Figure 4). Cortical screws were placed in the 8-hole plate engaging C7 and T2-T4 following removal of the Kirschner wires (Figure 5).
Intraoperative image showing paired, adjacent string of pearl plates (white arrows).
CRIVEM2018-9152394.005.jpg
PMC6151845_01_CRIVEM2018-9152394.005.jpg
fig5
C7-T3 and placed adjacent to the first plate. 2.0mm cortical screws (DePuy Synthes, West Chester, Pennsylvania) were placed in holes engaging C7, T1, and T3 in the 6-hole plate (Figure 4). Cortical screws were placed in the 8-hole plate engaging C7 and T2-T4 following removal of the Kirschner wires (Figure 5).
(a) Postoperative ventrodorsal radiographic projection of the cranial thoracic spine at the level of the spinal subluxation. Juxtaposed string of pearl plates are secured from the C7 to T4 vertebral bodies. The 8-hole plate on the dog's left engages vertebral bodies C7, T2, T3, and T4. The 6-hole plate on the dog's right side engages vertebral bodies C7, T1, and T3. Two wires are noted from the medial sternotomy closure superimposed over the 6-hole plate. (b) Postoperative lateral radiographic projection of the cranial thoracic spine at the level of the spinal subluxation. Screws are noted to engage vertebral bodies of C7-T2 cranial to the injury. Three screws engage vertebrae T3 and T4.
CRIVEM2018-9152394.006.jpg
PMC6151845_01_CRIVEM2018-9152394.006.jpg
fig6
Postoperative radiographs indicated apparent appropriate implant placement, though the T2-T3 disc space remained collapsed (Figure 6).
This image is a gap corrected reconstructed CT parasagittal slice of the dog's spine eight weeks postoperatively. The T2-T3 disc space remained collapsed but the degree of luxation was consistent with preoperative imaging. The two caudal screws are noted to protrude slightly into the spinal canal (white arrows).
CRIVEM2018-9152394.007.jpg
PMC6151845_01_CRIVEM2018-9152394.007.jpg
fig7
T2-T3 remained collapsed, the luxation of T2-T3 was consistent with initial postoperative radiographs, and the T2 caudal endplate fracture was ill-defined. The two most distal screws protruded into the vertebral canal but spinal cord compression was not suspected (Figure 7).