Median manubriotomy for ventral access to the caudal cervical and cranial thoracic spine

• Published in: Veterinary surgery Vol. 49; no. 5; pp. 923 - 929
• Main Author: Mateo, Isidro
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-07-2020; Blackwell Publishing Ltd
• Subjects: Cadavers; Complications; Decompression; Diagnostic systems; Dogs; Extrusion; Intervertebral discs; Lesions; Medical records; Misalignment; Population studies; Skull; Spinal cord; Spine; Spine (thoracic); Surgery; Thromboembolism; Vertebrae
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.13412

Objective
To describe median manubriotomy to access the ventral aspect of the caudal cervical and cranial thoracic spine and report the outcomes in dogs with lesions affecting the spinal cord at C6‐T2 vertebral bodies. To evaluate possible complications of this technique and clinical outcomes.
Study design
Cadaveric study and short case series.
Study population
Two cadavers and nine dogs with lesions affecting the spinal cord at C6, C7, T1 or T2 vertebral bodies or corresponding intervertebral spaces.
Methods
Two cadavers were used for demonstration purposes. Medical records (2013‐2019) were reviewed for dogs undergoing median manubriotomy to facilitate access to the ventral aspect of C6‐T2 vertebral bodies and/or corresponding intervertebral disc spaces. Data on preoperative and postoperative neurological status and diagnostic imaging, surgical technique, and complications were retrieved.
Results
Indications for surgery included C7‐T1 disc extrusions in five dogs, caudal cervical misalignment in three dogs, and C7‐T1 and T1‐T2 disc protrusions in one dog. The vertebral bodies of C6 to T2 were consistently visualized after median manubriotomy. Preoperative clinical signs resolved in five dogs and improved in two dogs. One dog was euthanized for lack of improvement, and one dog died of pulmonary thromboembolism.
Conclusion
Median manubriotomy improved the surgical access to the ventral aspect of caudal cervical and cranial thoracic spine without related complications.
Clinical significance
Median manubriotomy can be considered in dogs undergoing ventral decompression and/or stabilization of C7‐T1 and T1‐T2 intervertebral disc spaces.