Outcomes after cervical vertebral interbody fusion using an interbody fusion device and polyaxial pedicle screw and rod construct in 10 horses (2015-2019).
Authors: Pezzanite Lynn M, Easley Jeremiah T, Bayless Rosemary, Aldrich Ellison, Nelson Brad B, Seim Howard B, Nout-Lomas Yvette S
Journal: Equine veterinary journal
Summary
# Editorial Summary: Cervical Vertebral Fusion in Horses Using Interbody Devices and Pedicle Screw Constructs Cervical vertebral compressive myelopathy remains a significant cause of ataxia in young horses, yet existing surgical stabilisation techniques are technically demanding and carry substantial complication rates. Researchers retrospectively evaluated 10 horses (aged 12–168 months) that underwent cervical interbody fusion using a novel polyaxial pedicle screw and rod construct between 2015 and 2019, assessing both objective gait improvement and owner-reported outcomes at follow-up intervals. Of eight horses with minimum one-year follow-up data, six showed ataxia improvement ranging from 1–3 grades (mean 1.25 grades), with four achieving near-normal or normal gait (grades 0–1), whilst two demonstrated improved neck comfort without gait changes; two horses required euthanasia within the first year. Whilst complications were frequent—notably seroma formation in nine of ten cases, post-operative pain in five, and screw breakage in two—no fatal implant-related adverse events occurred, and functional outcomes matched or exceeded those reported with traditional ventral fusion approaches. This technique warrants consideration as a potentially more manageable alternative to standard cervical stabilisation procedures, though the small sample size and high complication rate necessitate further investigation before widespread clinical adoption.
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Practical Takeaways
- •Interbody fusion with polyaxial pedicle screws and rods can improve cervical ataxia in horses with vertebral compression, with 60-75% achieving meaningful functional improvement
- •Expect high seroma formation rates (90%) and postoperative pain in most cases; plan appropriate management protocols for these anticipated complications
- •This technique appears safer than traditional ventral fusion approaches with comparable outcomes, making it a viable alternative for referral cases
Key Findings
- •6 of 8 horses with ≥1-year follow-up showed ataxia improvement of 1-3 grades (average 1.25 grades), with 4 horses reaching grade 0-1
- •Seroma formation was the most common complication (9/10 horses), followed by pain (5/10) and fever (4/10)
- •Two horses were euthanised within the first year; fatal complications related to implant placement did not occur
- •Gait outcomes were similar to other ventral interbody fusion methods but with potentially fewer fatal complications