Presentation.
This lesion, depending on the extent of trauma to the nerve roots (and the individual nerve roots affected) could have an influence on femoral nerve function (stifle and hock extension), sciatic nerve function (hock flexion and digital extension), abductor function (hind limb abduction) and any combination of sacral, pudendal and pelvic nerves contributing to bladder function (so the cat could appear to have a tail-pull injury, with urine retention).
There was urine retention, but tail base sensation and conscious hindlimb motor function were present. This was good prognostic sign. Surgical stabilization dramatically increases comfort for these patients and provides the best potential for functional recovery.
Lumbo-sacral stabilisation.Surgery
Surgery was performed the following day, by our surgeon Phil Witte, through dorsal midline approach to the Lumbo-sacral junction. Rigid fixation was achieved using parallel 2.0mm SOP plates with four screws in L7 (The pedicles of the L7 vertebra are considerably thicker than pedicles in other lumbar vertebrae and can accommodate screws) and four screws in S1/2 (diverging into sacral wings).
The patient remained hospitalised for 72 hours following surgery to monitor bladder function. At the time of discharge Lyla was ambulatory and comfortable.
Outcome.
The 4-week follow-up radiographs demonstrated no implant related issues and no obvious displacement of the stabilised L7 – S1 junction. Gradual return to normal exercise was recommended.
Further reading.
See more on these condition in cats by reading Phil’s article in The Vet Times here.
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