Caudal Cervical Spondylomyelopathy

[lehughes]

Hi Laurie,

I hope everything is OK with you at the moment.
I recently viewed your video training talks on geriatric wobblers.
I am soon to see a Great Dane who has had a dorsal laminectomy for wobblers and is not 6 weeks post op and not progressing too well. I do not have all the details yet.
My question is - is traction advocated for disc related compression only? Is it still something that can be done following spinal surgery, given there may be less structural support to the area?
As young Great Danes have the potential for the vertebral abnormalities etc and the disc may be involved, I wasn't sure if traction can help with hypertrophy or hyperplasia of the ligament flavum also?
I cannot find any information either way.
Thank you for your time.

Kind Regards,

E.W.

[lehughes]

Hi E,

I hope all is well in your neck of the woods as well!

Okay, so as for traction research, and research of traction in canines, I would say… it’s not there. Nowhere. Nobody has done it.

But here’s how I would thought process it. We know that often when doing a myelogram for CaCSM (caudal cervical spondylomyelopathy… wobblers… I just like to practice saying the other bit fast so it can roll off my tongue), they will do a regular view and a distracted / tractioned view. Often times if there is improvement with the tractioned view, that is a positive sign that decompressive surgery could be of benefit. As such, I have taken the stance that traction is likely to be of some benefit in all wobblers cases. Can it cure the young Great Dane… no, but maybe it will improve quality of life and allow for blood flow and healing to occur at the site of the lesion… resulting in some degree of functional improvement.

So, all in all… sounds like you are this dog’s only hope. Traction, Laser, Acupuncture, PEMF… whatever you have up your sleeve.

Best of luck!

Laurie

[lehughes]

Thanks Laurie, that makes sense. Have to admit to saying it fast a few times but doesn’t seem to roll if my tongue! Haha
Cheers E

[larm40]

Hello
what are your thoughts on a soft neck brace for these patients? I had someone tell me one that they had tried a make shift cervical collar that they put on a Wobblers dog and it seemed to make a difference in the dogs ability to balance itself better? This person told me they made it with a rolled towel and duck tape, had the dog wear it when up and moving around? I have never heard or seen any information on it. ?? just curious

[lehughes]

Good question Laura!
So I have not used a neck brace. Here's my thinking in multiple parts.

1. If the lesion is C6 and caudal, then bracing the neck cranial than that would simply cause increased mobility caudally. Actually, it's questionable as to whether it would stabilize C5 either.
2. Bracing reduces muscle use / tone / strength. We rarely recommend neck braces any more in people for this reason - however very short term use after a motor vehicle accident can sometimes give people some symptomatic relief... but one thought is that it's mostly psychological.
3. What are we trying to stabilize? In the geriatric wobblers or wobblers with ligamentous hypertrophy, it's not a stability problem anyways. Yes, there might be a portion of the young wobblers dogs with an instability. But then you refer yourself back to item #1.
4. Could it worsen things? As point #1 brings up, it might make a hypermobile segment adjacent to the stability actually have to work / move more. As point #2 brings up, it might result in muscle atrophy and subsequently less stability as well. And the other point is that by impeding movement, there is also an impeding of circulation, which is what would be needed to help heal tissues and/or remove products of inflammation, etc.

So I've not recommended a neck brace, and I don't think that I can see much or any cases where I might. (But I've not put much thought into that... simply for THIS kind of case, I don't think I would.)

Thanks for bringing that up!

Cheers,

Laurie