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

Authors: 
Mateo I
Vet Surg. 2020 Mar 12. 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.

Small animal: