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Vertebral body plates are orthopedic plates that are fixed internally to your dog's vertebrae to provide stabilization when disorders of the vertebral column occur. Disorders such as fractures, dislocations, or degenerative diseases in the vertebral column may require surgical intervention to provide stabilization with plates. Vertebral body plates specifically refer to plates that are used over the span of several vertebrae processes to provide stabilization and structure when needed. These specialized orthopedic plates are placed surgically and fixed with surgical pins and screws by a specially trained orthopedic veterinary surgeon while your dog is under general anesthetic.
Prior to the placement of vertebral body plates, extensive radiographs will be taken to use for determining the appropriate approach and placement of vertebral body plates. Prior to surgery, your dog will undergo routine blood testing to ensure that other disease is not present that would compromise your dog during surgical intervention and administration of anesthesia. You will be required to fast your dog 12 hours prior to surgery.
On the day of surgery your dog will be sedated, administered intravenous anesthetic to put your dog into a deep sleep, and an esophageal tube inserted and anesthesia maintained by gas for the duration of the procedure to ensure your dog's comfort. Antibiotics, anti inflammatories and analgesics will be administered to ensure post operative comfort and recovery.
Your dog’s dorsal area, above the area to be surgically opened, will be shaved and cleaned antiseptically, and isolated with surgical draping. An incision will be made to expose the multiple vertebral structures that require vertebral body plating. Muscles will be dissected away, spinal vessels and nerves are carefully manipulated out of the way and protected during the process. Nerves and vessels that will be compromised by plate placement are ligated and transected. If rib heads are present at the vertebral processes to be plated, they will be retracted and cut with bone cutting tools, and after plate placement they will be reattached with wires inserted through holes drilled through the rib heads and reattached to the vertebra. Vertebral processes are realigned or repaired and holes are drilled in the dorsolateral surface of the vertebra. Bone grafting may be conducted as part of vertebral repair if necessary, prior to plate placement. The vertebral body plates are attached with screws into predrilled holes in the vertebral processes to align and secure the vertebra. After repair and plate placement has been achieved, incisions are closed and your dog will be assisted in recovery from anesthetic.
Vertebral body plating is especially effective in areas subject to bending, as plates are able to withstand compressive forces. Vertebral processes where shortening is evident benefit from this. Vertebral body plates may not be practical in the cranial thoracic region of the vertebra as these are difficult to expose and work with. In addition, surgical intervention caudal to the fifth lumbar vertebra can result in nerve damage resulting in neurological issues and dorsolateral body plating in this area can only be conducted if nerve roots can be protected and preserved during the procedure.
Radiographs will be taken after the procedure and before your dog recovers from anesthesia to assess plate placement. Anti-inflammatories and analgesics will be administered for at least 24 to 48 hours post surgery. You dog should be closely monitored after surgery for signs of complications with respiration or signs of neurological impairment. The incision should be checked for signs of infection or rupture and your dog should not be allowed to interfere with the incision. If they are able to reach the incision they may need an e-collar to prevent this, although locations on the back may prevent access by your dog. Cage rest will be required for an extended period of time, from 4 to 8 weeks. Follow-up radiographs will be conducted to confirm placement of plates, vertebral stabilization and healing prior to a return to normal activity. Sutures will need to be removed 10 to 14 days after surgery. Post-surgery, dogs should be walked with body harnesses instead of neck collars, and they should be discouraged from jumping on furniture on an ongoing basis. Placement of carpeted steps to allow your dog to reach a bed or favorite piece of furniture should be used if necessary.
This procedure requires expertise by a veterinary orthopedic surgeon and specialized surgical orthopedic plating of the appropriate size. Multiple radiographs and planning will need to be conducted and follow-up tests and assessments conducted. The cost of vertebral body plate placement in dogs ranges from $2,000 to $5,000 depending on the cost of living in your area and the expertise required to affix plates in the vertebral column. Some areas of the vertebral column are more complex to access, and require more intervention to repair and affix vertebral body plates, which may contribute to variations in cost.
Neurological deficits are possible post surgery if nerve damage occurs during the surgical procedure. Pre-surgery planning can help mitigate this. Implant failure is also an issue and appropriate sizing of vertebral body plates, along with adequate screw or pin placement, will increase the chances of the implant being successful.
Respiratory issues are associated with this surgery in the cervical region and care to preserve critical laryngeal nerves is critical. Dogs with respiratory problems, such as brachycephalic breeds, requiring intervention in the cervical area due to subluxations, are especially prone to respiratory issues associated with vertebral surgeries. Dogs should be monitored post surgery for respiratory compromise.
Chronic pain can be experienced by dogs undergoing vertebral surgery if repair of the underlying vertebral condition is inadequate to resolve discomfort prior to stabilization being provided. Surgical pre-planning and ensuring that the spinal cord is decompressed and vertebra aligned prior to fixation is critical to ensuring the dog’s comfort postoperatively.
Degenerative diseases in dogs can be mitigated by ensuring your dog is in good physical condition and does not become overweight. Providing an appropriate diet and exercise is important. Preventing vertebral injuries by keeping your dog on a leash or in an enclosed area will reduce the likelihood of common injuries dogs experience from falls, motor vehicle accidents and altercations with other dogs. In addition,, using a harness instead of a neck collar may prevent neck injuries in your dog as well as reduce other injuries such as tracheal injury.
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