한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제30권6호
  • /
  • Pages.499-502
  • /
  • 2013
  • /
  • 1598-298X(pISSN)
  • /
  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지

중쇠뼈 찢김골절로 인한 고리중쇠 관절 불안정의 교정

Correction of Atlanto-axial Instability by Avulsion Fracture of the Axis in a Dog

  • Hwang, Yong-Hyun (Pet's all animal hospital) ;
  • Kim, Minkyung (Institute of animal medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Park, Jung-Hyun (Institute of animal medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Jin, So-Young (Institute of animal medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Park, Ki-Tae (Institute of animal medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Hee-Chun (Institute of animal medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Jae-Hoon (Institute of animal medicine, College of Veterinary Medicine, Gyeongsang National University)
  • 심사 : 2013.10.24
  • 발행 : 2013.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목 부위에 교상을 입은 8살의 중성화된 수컷 푸들이 내원하였다. 신체 검사에서, 보행이 불가능하였고 심부통증이 있는 사지의 불완전 마비로 UML 증상을 보였다. 방사선과 CT 검사에서 경추 1번의 횡돌기의 골절, 경추 2번의 가시돌기의 골절이 관찰 되었다. 보존적 처지를 1주일 실시 하였으나 증상이 완화 되지 않아 수술적 교정이 선택되었다. 수술적 안정은, 배쪽으로 접근하여 나사, K-wires 와 bone cement를 이용하여 내원 7일차에 실시 되었다. 수술 후 4주 이후 혼자 설 수 있었으며, 6주 이후 보행이 가능하였다. 본 증례에서는 등쪽과 배쪽 부위 중쇠뼈 골절을 교정하기 위하여 배쪽 복합 고정을 실시하였으며, 좋은 예후를 보였다.

An eight-year-old, castrated male, Poodle dog was presented with a bite wound in the neck region. Clinical examination revealed non-ambulatory signs of tetraparesis with deep pain, and upper motor neuron changes in all limbs. Fractures of the transverse process of C1 and the dorsal spinous process of C2 were observed on the radiographs and the computed tomography (CT). Conservative therapy was performed for 1 week. However the neurological problems were not alleviated until 7 days after injury. The owners agreed to perform surgical stabilization. The surgical stabilization was performed 7 days after presentation. Ventral stabilization was performed with screws, K-wires and bone cement. The dog stood up independently after 4 weeks and was able to walk 6 weeks postoperatively. In this report we suggest that using combined stabilization techniques are effective for this type of cervical fracture in which the dorsal and ventral structures of the vertebra are severely disrupted.

키워드

참고문헌

  1. Bruce CW, Brisson BA, Gyselinck K. Spinal fracture and luxation in dogs and cats: a retrospective evaluation of 95 cases. Vet Comp Orthop Traumatol 2008; 21: 280-284.
  2. Fluehmann G, Doherr MG, Jaggy A. Canine neurological diseases in a referral hospital population between 1989 and 2000 in Switzerland. J Small Anim Pract 2006; 47: 582-587. https://doi.org/10.1111/j.1748-5827.2006.00106.x
  3. Hawthorne JC, Blevins WE, Wallace LJ, Glickman N, Waters DJ. Cervical vertebral fractures in 56 dogs: a retrospective study. J Am Anim Hosp Assoc 1999; 35: 135-146. https://doi.org/10.5326/15473317-35-2-135
  4. Jeffery ND. Dorsal cross pinning of the atlantoaxial joint: new surgical technique for atlantoaxial subluxation. J Small Anim Pract 1996; 37: 26-29. https://doi.org/10.1111/j.1748-5827.1996.tb01930.x
  5. Jeffery ND. Vertebral fracture and luxation in small animals. Vet Clin North Am Small Anim Pract 2010; 40: 809-828. https://doi.org/10.1016/j.cvsm.2010.05.004
  6. Marioni-Henry K, Vite CH, Newton AL, Van Winkle TJ. Prevalence of diseases of the spinal cord of cats. J Vet Intern Med 2004; 18: 851-858. https://doi.org/10.1111/j.1939-1676.2004.tb02632.x
  7. McCarthy RJ, Lewis DD, Hosgood G. Altantoaxial subluxation in dogs. Compend Contin Educ Pract Vet 1995; 17: 215-217.
  8. McKee WM. Spinal trauma in dogs and cats: a review of 51 cases. Vet Rec 1990; 126: 285-289.
  9. Ozak A, Nisbet HO, Yardimci C, Sirin YS. Stabilisation with dorsal and ventral fixation of a traumatic cervical instability in a dog. Aust Vet J 2009; 87: 413-416. https://doi.org/10.1111/j.1751-0813.2009.00485.x
  10. Sanders SG, Bagley RS, Silver GM, Moore M, Tucker RL. Outcomes and complications associated with ventral screws, pins, and polymethyl methacrylate for atlantoaxial instability in 12 dogs. J Am Anim Hosp Assoc 2004; 40: 204-210. https://doi.org/10.5326/0400204
  11. Schulz KS, Waldron DR, Fahie M. Application of ventral pins and polymethylmethacrylate for the management of atlantoaxial instability: results in nine dogs. Vet Surg 1997; 26: 317-325. https://doi.org/10.1111/j.1532-950X.1997.tb01504.x
  12. Sharp NJH, Wheeler SJ. Atlantoaxial subluxation. In: Small animal spinal disorders. 2nd ed. Philadelphia: Elsevier. 2005: 161-180.
  13. Struges BK, LeCouteur RA. Vertebral fractures and luxations. In: Textbook of small animal surgery. 3rd ed. New York: WB Saunders. 2002: 1244-1260.