Cervical stabilization with polyaxial pedicle screw and rod construct in horses: A proof of concept study.
Authors: Aldrich Ellison, Nout-Lomas Yvette, Seim Howard B, Easley Jeremiah T
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Cervical Stabilization with Polyaxial Pedicle Screw and Rod Constructs in Horses Cervical vertebral compressive myelopathy (CVCM) remains a significant cause of neurological dysfunction in horses, and surgical stabilization options have been limited. Ellison and colleagues evaluated a novel surgical technique combining interbody fusion with polyaxial pedicle screw and rod fixation at the C3-C4 level in four healthy quarterhorses over an 8-month period, assessing safety through clinical monitoring, radiographic analysis, and detailed histological and micro-CT examination of the fusion sites. The procedure was successfully completed without severe complications, with no evidence of implant failure, migration, or instability on serial radiographs, and micro-CT confirmed new bone formation around the construct in all horses. Histological assessment revealed appropriate osseointegration and no inflammatory response or iatrogenic damage, though bone incorporation within the interbody device itself was variable across subjects. Although this proof-of-concept study was necessarily limited to sound horses, the technical feasibility and biological response demonstrated here provide sufficient evidence to warrant clinical trials in horses presenting with cervical myelopathy, potentially offering improved outcomes over current stabilization techniques for this challenging condition.
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Practical Takeaways
- •This proof-of-concept demonstrates a potentially viable surgical option for treating cervical vertebral compressive myelopathy, though clinical efficacy and long-term outcomes remain to be established in affected horses
- •The technique successfully achieves spinal stabilization without major complications, but variable osseointegration suggests timing and implant design may need optimization for clinical practice
- •Further clinical trials are needed before this technique can be recommended for routine use in practice; current findings support progression from experimental to clinical application
Key Findings
- •Polyaxial pedicle screw and rod construct successfully stabilized C3-C4 spinal unit in all 4 horses without severe postoperative complications
- •No implant failure, migration, or spinal instability observed on radiographic follow-up over 8 months
- •Micro-CT and histology confirmed new bone formation around implants with variable osseointegration at cranial and caudal surfaces
- •Novel cervical fusion technique proved safe and feasible as proof of concept, justifying further evaluation in clinical disease