Internal fixation of a fractured cranial articular process of the sixth cervical vertebra by means of computer-assisted surgery in a Warmblood gelding.
Abstract: To describe the repair of a fractured cranial articular process (AP) of the sixth cervical vertebra (C6) with cortex screws placed in lag fashion using computer-assisted surgery. Methods: A 12-year-old Swiss Warmblood gelding. Methods: Case report. Methods: The gelding was presented with neck pain and ataxia after a fall. A fracture of the right cranial AP of C6 was identified on radiographs. The fracture was repaired by internal fixation with two 4.5 mm cortex screws of 58 and 48 mm length placed in lag fashion using computer-assisted surgery. Results: During general anesthesia, it was suspected that the gelding developed brain edema that prolonged the recovery process. Postoperatively, the horse showed transient ataxia and myopathy of the left triceps muscle. Except for focal muscular atrophy of the right supraspinatus muscle, all complications resolved. Radiographs confirmed healing of the fracture with minimal callus formation. One year after surgery, the gelding had returned to ridden exercise and was performing well. Conclusions: Computer-assisted surgery facilitates lag screw fixation of AP fractures and makes this a potential alternative to intervertebral body fusion, which is recommended for this type of fracture to avoid excessive callus formation and subsequent spinal cord or cervical spinal nerve compression.
© 2025 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Publication Date: 2025-05-23 PubMed ID: 40406914DOI: 10.1111/vsu.14273Google Scholar: Lookup
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Summary
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This research documents the repair of a fractured cranial articular process (AP) of the sixth cervical vertebra (C6) in a 12-year-old Swiss Warmblood horse using computer-assisted surgery. The horse was able to return to its normal activities one year after the procedure.
Objective and Methodology
- The purpose of this research was to describe a new technique of managing fractures in horses – specifically, a fractured cranial articular process (AP) in a horse’s sixth cervical vertebra (C6).
- This was done through a case report involving a 12-year-old Swiss Warmblood gelding that was presented with neck pain and uncoordinated movement (ataxia) after falling.
- The use of radiographs confirmed the presence of the fracture and computer-assisted surgery was used to repair it. Two cortex screws, measuring 58mm and 48mm, were placed in a lag fashion to fixate the injury internally.
Findings and Observations
- During the surgery, the horse was suspected to have developed brain edema (swelling), which prolonged its recovery process. Following the operation, the horse presented transient ataxia and left triceps myopathy (muscle disease).
- However, with time, all complications, except for focal muscular atrophy (shrinking) of the right supraspinatus muscle, resolved.
- Radiographs taken after the surgery confirmed successful healing of the fracture with minimal formation of callus (extra bone that grows around a healing fracture).
- One year after the surgery, the gelding had returned to its normal routine of ridden exercise and was performing well.
Conclusion and Implication
- The findings suggest that computer-assisted surgery enhances the process of lag screw fixation of AP fractures, making it a potential alternative to intervertebral body fusion, which is typically recommended for this type of fracture.
- Such alternate treatment can prevent excessive callus formation that could potentially compress the spinal cord or cervical spinal nerves, leading to additional health issues.
- This study’s results contribute valuable knowledge to the field of veterinary medicine, particularly in the application of computer-assisted surgical techniques for effective treatment of specific equine bone injuries.
Cite This Article
APA
Käfer-Karrer MJ, de Preux M, Van der Vekens E, Mattei LI, Kuhlmann J, Klopfenstein Bregger MD, Easley JT, Koch C.
(2025).
Internal fixation of a fractured cranial articular process of the sixth cervical vertebra by means of computer-assisted surgery in a Warmblood gelding.
Vet Surg.
https://doi.org/10.1111/vsu.14273 Publication
Researcher Affiliations
- Division of Equine Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Division of Equine Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Section of Anesthesiology and Pain Therapy, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Division of Equine Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Division of Equine Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA.
- Division of Equine Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
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