Neurology Specialists use unique spinal guide to stabilise dog's vertebrae during surgery Image Geralt has made a full recovery following surgery to release the fluid and stabilise his spine. Veterinary neurology specialists from the Royal (Dick) School of Veterinary Studies have used a made-to-measure 3D printed guide to help stabilise a dog’s spine during surgery. Whilst surgeons successfully drained spinal fluid, the guide provided safe corridors to place screws and stabilise the vertebrae.The young dog recovered quickly following surgery and his full neurological function has been restored. Geralt’s storyGeralt, a one-year-old pug, was referred to the Neurology Service by his veterinary surgeon, with a history of long-term, non-painful progressive unsteadiness and weakness affecting his back legs. He also had urinary and faecal incontinence.MRI and CT scans confirmed a diagnosis of a spinal arachnoid diverticulum (SAD). SAD is an abnormal accumulation of cerebrospinal fluid in the meninges, which are the layers of tissue surrounding the spinal cord. The pressure of the fluid compresses the spinal cord and leads to several neurological problems, including faecal and urinary incontinence, limb weakness and ataxia – an unsteady gait.Additionally, certain connecting joints within Geralt’s vertebrae, that help maintain the stability of his vertebral column, were absent.Surgical solution Image A selection of MRI images. Comparison of [A] normal spinal cord (dotted red circle) and [B] Geralt’s compressed spinal cord (dotted red circle) due to the build-up of cerebrospinal fluid (highlighted by the blue arrow). [C] Geralt’s spinal arachnoid diverticulum (highlighted by blue arrow) running along his spinal cord. After discussing the various options with Geralt’s owners, it was agreed that surgery to release the fluid and stabilise Geralt’s vertebrae would give the best improvement to his long-term neurological function.CT scan images were used to commission a 3D-printed guide to fix around the dog’s vertebrae during surgery, made by collaborating with Fusion implants Ltd. The guide was printed to match Geralt’s body with millimetre accuracy and had corridors to enable surgeons to drill, then insert screws into the affected vertebrae with precision. They then used bone cement around the screws to help fuse the bones to prevent the condition from reoccurring. Geralt recovered quickly from surgery; his incontinence was resolved and he soon regained full strength in his hind legs, restoring his mobility. Image Neurosurgeons used a 3D-printed drill guide fixed to Geralt's spine during surgery. Uncommon conditionSAD is a debilitating condition. Although the condition is not painful, if left untreated the symptoms can worsen over time, affecting the dogs’ quality of life and the owner's quality of life, too.The cause of SAD is unknown. There is a suggestion that there may be a genetic component as some breeds seem to have a disposition to the condition. SAD could also be acquired due to disturbance of the flow of spinal fluid around the vertebrate, either due to inflammation of the membranes, previous trauma or instability of the vertebrae.Neurology SpecialistsThe Neurology Service at the Hospital for Small Animals is one of the largest veterinary neurology referral services in Europe. The team consists of five European Diplomates in Neurology and Neurosurgery, four residents and two dedicated neurology nurses, ensuring the highest level of veterinary care for patients referred to the Hospital with neurological problems.Although rare in the general dog population, the Neurology Service regularly treat dogs referred to the Hospital with SAD. In the last 12 months, the team has successfully operated on five dogs with SAD, with each animal affected at different points in their neck and spine. It was a joy for us to see Geralt begin his new life after the surgery. We were scared at first, but Geralt immediately responded well after the surgery. Now he is happy, he runs and plays with other dogs and enjoys his life to the fullest. Thank you all for the hard work and help. The Di Marco’s Geralt's owners We are delighted to offer surgical solutions for animals with SAD and are keen to see how we can adopt the technology of using 3D models for other neurological uses. Dr Aran Nagendran Co-Head of Neurology Service, Hospital for Small Animals About the Royal (Dick) School of Veterinary Studies The Royal (Dick) School of Veterinary Studies is a one-of-a-kind centre of excellence in clinical activity, teaching and research. Our purpose-built campus, set against the backdrop of the beautiful Pentland Hills Regional Park, is home to more than 800 staff and almost 1400 students, all of whom contribute to our exceptional community ethos. The School comprises: The Roslin Institute The Global Academy of Agriculture and Food Systems The Roslin Innovation Centre The Hospital for Small Animals Equine Veterinary Services Farm Animal Services Easter Bush Pathology The Jeanne Marchig International Centre for Animal Welfare Education We represent the largest concentration of animal science-related expertise in Europe, impacting local, regional, national and international communities in terms of economic growth, the provision of clinical services and the advancement of scientific knowledge. Tags Vet School Publication date 25 Jun, 2024