Multicenter results for C7-T1 ventral interbody fusion in horses using the kerf cut cylinder.

Research Overview

• This study evaluates the surgical approach and outcomes of C7-T1 ventral interbody fusion using a kerf cut cylinder (KCC) implant in horses diagnosed with cervical vertebral stenotic myelopathy.
• The research summarizes both short- and long-term results, indicating that the procedure is feasible with acceptable risks and good prognosis in equine patients.

Introduction and Purpose

• The surgery focuses on treating C7-T1 cervical vertebral stenotic myelopathy, a spinal condition causing compression and neurological deficits in affected horses.
• Ventral interbody fusion aims to stabilize this cervical segment by inserting an implant to promote fusion between vertebrae.
• The kerf cut cylinder (KCC) is a specific type of implant used for this fusion procedure.
• The study’s objective was to describe the surgical approach, report intraoperative and anesthesia complications, and evaluate the short- and long-term clinical outcomes after the procedure in a large multicenter group of horses.

Methods

• This was a retrospective observational study reviewing medical records from 2004 to 2024.
• A total of 38 client-owned horses with C7-T1 cervical vertebral stenotic myelopathy that underwent the KCC ventral interbody fusion were included.
• Preoperative data collected: age, sex, breed, and specific affected vertebral sites.
• Surgical variables included:
  • Types of KCC implants used
  • Intraoperative complications
  • Anesthesia-related complications
• Long-term outcomes were assessed through telephone interviews with owners, trainers, or attending veterinarians to gather post-discharge status and performance ability.

Results

• Out of 38 horses treated, 34 (89%) were discharged alive and survived more than three months post-surgery.
• The median long-term follow-up period was 48 months, ranging from 3 to 144 months, with data available for 32 horses.
• Two horses were lost to long-term follow-up.
• Successful outcomes were observed in 79% of the cases (30/38 horses), meaning significant clinical improvement or return to function.
• Specific outcome details:
  • 50% (19/38) returned to active riding, training, or competitive showing.
  • 29% (11/38) either had unrestricted turnout or were undergoing rehabilitation with notable clinical improvement.
• Laryngeal spasm was identified as the most common short-term complication associated with the surgery.

Discussion and Conclusions

• Performing ventral interbody fusion at the C7-T1 vertebral level presents anatomical challenges due to the location.
• Despite these challenges, the usage of the KCC implant had acceptable morbidity, meaning postoperative complications were manageable and not overly severe.
• The procedure is shown to be effective in improving clinical signs and restoring function in many horses with cervical myelopathy affecting this critical spinal region.
• The study advises that ventral interbody fusion of the cervical spine, particularly using KCC for C7-T1, should no longer be viewed solely as a salvage (last-resort) procedure but rather a viable treatment option.

Implications for Equine Veterinary Practice

• This work supports offering surgical fusion with KCC implants to horses suffering from C7-T1 cervical vertebral stenotic myelopathy.
• Veterinarians should anticipate and manage risks such as laryngeal spasm but can counsel owners on good chances of recovery and return to athletic activity.
• Long-term follow-up data reinforce the durability of benefits from this surgical approach.