RSS-Feed abonnieren
DOI: 10.3415/VCOT-15-12-0201
Evaluation of the use of intra-operative radiology for open placement of lag screws for the stabilization of sacroiliac luxation in cats
Publikationsverlauf
Received:
09. Dezember 2015
Accepted:
10. Oktober 2016
Publikationsdatum:
26. Dezember 2017 (online)
Summary
Objectives: To assess the effect of intra- operative radiology on the quality of lag screw insertion for the management of sacroiliac joint luxations in cats.
Methods: In this retrospective single-centre study, the surgical, anaesthetic and imaging records of 40 screws (32 cats) placed with lag effect for management of sacroiliac luxation were reviewed. Postoperative radio-graphs were assessed for sacroiliac joint reduction, screw position, and sacral width purchased by each screw. Cases were divided into two groups according to the use of (IOR) or the absence of intra-operative radiology (NIOR).
Results: A total of 23 lag screws were placed with the aid of intra-operative radiology and 17 without. Three of the 23 screws placed in the IOR group exited the sacrum as opposed to eight of 17 screws in the NIOR group (p = 0.03). Mean sacral width purchased by the screws in the IOR group (70.8%) was also significantly higher (p = 0.002) than in the NIOR group (54.6%). Mean general anaesthetic times for unilateral and bilateral screw placement for the IOR group and NIOR group were not significantly different.
Clinical significance: The use of intra-operative radiology can significantly improve the quality of lag screw insertion for the stabilization of sacroiliac luxations in cats, which should lead to a reduced incidence of postoperative screw loosening.
-
References
- 1 Lanz OI.. Lumbosacral and pelvic injuries. Vet Clin North Am Small Anim Pract 2002; 32: 949-962.
- 2 Meeson R., Corr S.. Management of pelvic trauma: Neurological damage, urinary tract disruption and pelvic fractures. J Feline Med Surg 2011; 13: 347-361.
- 3 Tomlinson J.. Minimally invasive repair of sacroiliac luxation in small animals. Vet Clin North Am Small Anim Pract 2012; 42: 1069-1077.
- 4 Shales CJ., White L., Langley-Hobbs SJ.. Sacroiliac luxation in the cat: defining a safe corridor in the dorsoventral plane for screw insertion in lag fashion. Vet Surg 2009; 38: 343-348.
- 5 Kaderly RE.. Stabilization of bilateral sacroiliac fracture-luxations in small animals with a single transsacral screw. Vet Surg 1991; 20: 91-96.
- 6 Shales C., Moores A., Kulendra E.. et al. Stabilization of sacroiliac luxation in 40 cats using screws inserted in lag fashion. Vet Surg 2010; 39: 696-700.
- 7 Raffan PJ., Joly CL., Timm PG.. et al. A tension band technique for stabilisation of sacroiliac separations in cats. J Small Anim Pract 2002; 43: 255-260.
- 8 Kudnig ST., Fitch RB.. Trans-ilial and transsacral brace fixation of sacral fractures and sacroiliac luxations (seven cases). Vet Comp Orthop Traumatol 2004; 17: 210-215.
- 9 Borer LR., Voss K., Montavon PM.. Ventral abdominal approach for screw fixation of sacroiliac luxation in clinically affected cats. Am J Vet Res 2008; 69: 549-556.
- 10 Kipfer NM., Montavon PM.. Fixation of pelvic floor fractures in cats. Vet Comp Orthop Traumatol 2011; 24: 137-141.
- 11 DeCamp CE.. Fractures of the pelvis. In: Tobias KE., Johnston SA.. editors. Veterinary Surgery: Small Animal. Vol 1 St Louis, Missouri: Elsevier Saunders; 2012: 809-813.
- 12 Burger M., Forterre F., Brunnberg L.. Surgical anatomy of the feline sacroiliac joint for lag screw fixation of sacroiliac fracture-luxation. Vet Comp Orthop Traumatol 2004; 17: 146-151.
- 13 Piermattei DL., Johnson KA.. An Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. Fourth edition. Philadelphia, Pennsylvania: Saunders; 2004
- 14 Tomlinson JL., Cook JL., Payne JT.. et al. Closed reduction and lag screw fixation of sacroiliac luxations and fractures. Vet Surg 1999; 28: 188-193.
- 15 Tonks CA., Tomlison JL., Cook JL.. Evaluation of closed reduction and screw fixation in lag fashion of sacroiliac fracture-luxations. Vet Surg 2008; 37: 603-607.
- 16 Leasure CS., Lewis DD., Sereda CW.. et al. Limited open reduction and stabilization of sacroiliac fracture-luxations using fluoroscopically assisted placement of a trans-iliosacral rod in five dogs. Vet Surg 2007; 36: 633-643.
- 17 DeCamp CE., Braden TD.. Sacroiliac fracture-separation in the dog: A study of 92 cases. Vet Surg 1985; 14: 127-130.
- 18 Vettorato E., Corletto F.. Retrospective assessment of peripheral nerve block techniques used in cats undergoing hindlimb orthopaedic surgery. J Feline Med Surg 2016; 18: 826-833.
- 19 Déjardin LM., Marturello DM., Guiot LP.. et al. Comparison of open reduction versus minimally invasive surgical approaches on screw position in canine sacroiliac lag-screw fixation. Vet Comp Orthop Traumatol 2016; 29: 290-297.
- 20 Fischer A., Binder E., Reif U.. et al. Closed reduction and percutaneous fixation of sacroiliac luxations in cats using 2.4 mm cannulated screws - a cadaveric study. Vet Comp Orthop Traumatol 2012; 25: 22-27.
- 21 Ledonio CGT., Polly DW., Swiontkowski MF.. Minimally invasive versus open sacroiliac joint fusion: are they similarly safe and effective?. Clin Orthop Relat Res 2014; 472: 1831-1838.
- 22 Smith AG., Capobianco R., Cher D.. et al. Open versus minimally invasive sacroiliac joint fusion: a multi-center comparison of perioperative measures and clinical outcomes. Ann Surg Innov Res 2013; 7: 14.
- 23 Schwarz T.. Artifacts in CT. In: Schwarz T., Saunders J.. editors. Veterinary Computed Tomography Chichester: John Wiley & Sons; 2011: 35-56.
- 24 Montavon PM., Voss K., Langley-Hobbs SJ.. Feline Orthopaedic Surgery and Musculoskeletal Disease. Mosby Elsevier 2009; 424-430.
- 25 DeCamp CE., Johnston SA., Déjardin LM.. et al. Brinker, Piermattei, and Flo’s Handbook of Small Animal Orthipaedics and Fracture Repair. Fifth Edition. Missouri: Elsevier; 2016: 436-467.
- 26 Mehlman CT., DiPasquale TG.. Radiation exposure to the orthopaedic surgical team during fluoroscopy: “How far away is far enough?”. J Orthop Trauma 1997; 11: 392-398.