Adaptation of Therapies Established in Clinical Neurosurgery to an Endangered Species

Guest D. James, MD, PhD, FRCS
Magdalena M. Dougherty, DVM
Sentiel Rommel DVM, PhD
David T Wise, DVM
Eric Belanger, MD, FRCS(C)
Gregory D. Bossart, DVM, PhD (Miami, FL)

Introduction:

Usually, surgical techniques are developed in animal models and translated to human application. We report a case in which techniques predominantly developed in clinical neurosurgery were applied to a critically endangered species. The Florida manatee is a severely endangered mammal. The rate of accidental death related to human activity has increased markedly in the past two decades. At current rates of population decline, extinction is likely. Thus, survival of each remaining manatee is important. We were asked to assist an injured adult manatee by reducing and instrumenting a fracture–dislocation and preventing meningoencephalitis following a severe spinal injury. In this report we discuss our decision–making process, anatomic and biomechanical considerations, and the urgency to protect this biologic and ecological resource. Use of fibrin glue for CNS slow–release antibiotic delivery in an open spinal injury has not been previously reported.

Methods:

This 800 pound manatee had sustained a severe propeller– induced complete thoraco–lumbar fracture dislocation, spinal cord transaction, and tissue excavation. We used fibrin glue to seal the open rostral spinal canal and locally deliver antibiotics (Amikacin). We achieved epidural anesthesia and attempted a simple reduction which was not successful. We therefore performed a corpectomy, spinal column shortening, and pedicle screw fixation.

Discussion:

Manatee bone is extremely dense increasing both insertions torque and pull–out strength. Because the spine is not subjected to gravitational loading we calculated that our fixation construct was adequate despite the animal's great mass.

Conclusion:

Therapeutic principles developed in humans can be transferred to members of critically endangered species.