Cervical OA and Basket Surgery (cervical interbody fusion) experience

[hallie2]

maybe this will help. I wrote an article about my horse’s fusion at nbc and Equus asked for success rates. this is what the surgeon said: ( article is supposed to be in this spring’s issue but you never know)

Hi Anne,

The French clinic that developed the implants we used on Sunny is putting together a retrospective on cases that have been done with this technique. So far between the 4 clinics that have been using it, 53 horses have been done. Overall, it appears that there is an average improvement of 1.5 grades of ataxia in the first year after surgery and average improvement of 1.9 grades in horses with > 1 year since surgery. Approximately 80% of owners are satisfied with the results. I am not sure how often the procedure is being done, but it does seem that more owners are electing surgery in the last 5-10 years versus doing nothing or putting the horse down due to pain and safety concerns around having an ataxic horse.
Let me know if you need anything else!

Kyla
Kyla Ortved, DVM, PhD, DACVS, DACVSMR
Associate Professor of Large Animal Surgery

[rzqh]

Thank you for your message and additional stats. I will watch for that article as well.

[hallie2]

this is a description of a study comparing new technique (spacer to replace disc and locking plates) vs Bagby surgery. the neurologist at nbc told me they do the spacer/locking plates because they are more biomechanically correct.

Novel surgery for horses with Wobblers Syndrome (CVSM, CVM, cervical...

[rzqh]

Great! I’ve been doing extensive research but had not come across that particular study. More info to add to my study. I appreciate your time and sharing.

[RAyers]

And when we do these procedures in humans, the failure rate of the procedure is 86% in two years that necessitate revision and reinstrumentation (ranges between 6 months and 7 years). I am highly suspicious of these procedures given how many human train wrecks I study. Spine fusion surgery (which is what they did with your horse) in humans is a last resort for pain relief.

53 horses is an insanely small power to be predictive. In my work my smallest power is 1200 patients (almost 20 years of data), although I publish studies with smaller numbers based on the outcomes to be analyzed and presented.

[hallie2]

Oh hi, you’re back, bringing cheery news. I know they did a spinal fusion in my horse, I’m a physician. I didn’t say it was a predictive study. According to new bolton, adjacent segment disease is not an issue in horses as it is in humans and dogs. This particular thread has been really helpful for those of us who decide to do fusions. And we all understand there are risks, some unknown. But we’ve decided to do the surgery instead of euthanizing our horses. If the alternative to fusion in humans was euthanasia, people would take the risk.

[RAyers]

At what point did I even suggest euthanasia is an option?

The reality is that right now, they DON’T know if adjacent segment disease is possible or not in horses. There is not even near enough numbers of follow up, and they don’t even have the capacity to do revisions. This is where human spine was 30 years ago.

Right now they are doing surgery based on what is an assumed geometry (just like we used to believe fusing the human spine straight was correct) without actually knowing what the equine spine is supposed to be.

Dog and any other quadruped can not be used as a comparison as the horse is the only animal we use competitively with a person on board. Very different biomechanics and genetics.

[Pezanos]

@RAyers

At what point did I even suggest euthanasia is an option?

This surgery is considered salvage surgery by vets.

[RAyers]

And there is the hitch that folks don’t realize when they do this to their horses. Their animal is an experimental subject. If it works, “yay!” Clients considering this should realize that this is salvage and not hitch themselves to this is a fix for my horse.

[Laurierace]

My mare was diagnosed with VEM at New Bolton in October. Your horse sounded very similar to mine but I think I suspect that in every NQR horse now. We were supposed to have a recheck to see if the Vitamin E supplementation alleviated all her symptoms or if we still had anything that needed addressing as she was also determined to be a 1 on the neuro scale but instead she had emergency surgery for a puncture wound that left numerous bone fragments in her collateral ligament so we are waiting until spring for that check

[NaturallyHappy]

I’m sorry to hear that!