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Neuropathology with spinal instrumentation.

J D Coe1, P S Becker, P C McAfee

  • 1Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
|January 1, 1989
PubMed
Summary
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Spinal instrumentation in beagles showed a significant increase in neurohistologic abnormalities, including nerve damage. Non-instrumented procedures had minimal impact, suggesting risks associated with spinal implants.

Area of Science:

  • Veterinary Neurology
  • Spinal Surgery
  • Neurohistology

Background:

  • Spinal destabilization procedures are common in veterinary medicine.
  • Assessing the neurohistologic impact of different spinal stabilization techniques is crucial.
  • Previous clinical reports suggest potential neurological complications with spinal instrumentation.

Purpose of the Study:

  • To compare the neurohistologic outcomes of spinal cord and cauda equina in beagles after various spinal destabilization and instrumentation procedures.
  • To evaluate the incidence of neurological damage associated with different surgical techniques.

Main Methods:

  • Neurohistologic examination of spinal cords and cauda equina from 28 beagles.
  • Four groups of dogs underwent different procedures: destabilized controls, bone grafting, Harrington instrumentation, and Luque instrumentation.

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  • Dogs were monitored for neurological integrity before death.

    • Main Results:

    • A statistically significant increase in neurohistologic abnormalities was observed in instrumented groups (64%) compared to non-instrumented groups (7%).
    • Abnormalities included Wallerian degeneration, cystic degeneration, and central cavitation.
    • The incidence of these changes was significantly higher with Harrington and Luque instrumentation.

    Conclusions:

    • Spinal instrumentation, particularly with sublaminar hooks or wires, is associated with a higher risk of subclinical neurohistologic injury.
    • Potential injuries include intraspinal and nerve root infarction.
    • The beagle model represents a "worst case situation," with expected lower clinical incidence.