Operative Techniques and Preliminary Outcomes Following Percutaneous Endoscopic Thoracolumbar Pediculectomy in Dogs

Hwang, Yong-Hyun; Lee, Hee-Chun; Lee, Jae‐Hoon

doi:10.1111/vsu.12569

Cited by 13 publications

(27 citation statements)

References 38 publications

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“…Surgical loupes are popular among neurosurgeons but offer only limited magnification. The use of exoscopes and endoscopes has been reported in a few veterinary reports . Video‐assisted ventral slots have been used in cadavers and in clinically affected dogs, whereas mostly cadaveric studies have been reported for the thoracolumbar and lumbosacral region, with only one report of using an endoscope in a study in live dogs .…”

Section: Discussionmentioning

confidence: 99%

“…Benefits associated with MISS strategy include smaller incision, less soft‐tissue damage, less blood loss, lower complication rate, less scarring, less postoperative pain, quicker recovery, shorter hospital stay, and a quicker return to daily life activity . Although MISS is common practice in human neurosurgery, limited reports have been published on its use for the thoracolumbar spine in dogs . All these reports except one (percutaneous endoscopic pediculectomy) refer to canine cadavers.…”

Section: Introductionmentioning

confidence: 99%

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Minimally invasive microsurgical decompression of an intervertebral disc protrusion in a dog

Guevar

Olby

2019

Veterinary Surgery

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Objective To report the successful treatment of intervertebral disc protrusion with minimally invasive microsurgery in a large breed dog. Study design Retrospective case report. Animal A 4‐year‐old, neutered male, German shepherd dog presented with chronic progressive ambulatory paraparesis and thoracolumbar pain; lumbar intervertebral disc protrusion and severe spinal cord compression at L2‐L3 were diagnosed. Methods A minimally invasive approach was used to access the target surgical area by using a muscle splitting technique and retractors. Intraoperative fluoroscopy confirmed correct placement. Magnification and illumination through a surgical microscope were used (microsurgery) to perform the spinal cord decompression by means of a foraminotomy and lateral corpectomy. Results Technically, the combination of fluoroscopy and muscle splitting approach offered adequate minimally invasive access. Microsurgery allowed for precise and efficient spinal cord decompression. Clinically, no immediate postoperative neurological deterioration was observed. Opioid usage was limited to 24 hours postoperatively. Focal muscle swelling was observed postoperatively for 2 days, and hospital stay was 3 days. At 7 weeks postoperatively, neurological examination results were normal, and postoperative MRI confirmed spinal cord decompression. No complications were reported. Conclusion The procedure was associated with a small incision, limited muscle trauma, early improvement of the neurological status, a short hospital stay, and limited postoperative pain. Clinical significance This case provides evidence that minimally invasive microsurgery is an effective treatment for intervertebral disc protrusion in large breed dogs and may offer benefits regarding postoperative pain and functional recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimally invasive microsurgical decompression of an intervertebral disc protrusion in a dog

Guevar

Olby

2019

Veterinary Surgery

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“…Standard approaches to the spine, so called open techniques , involve muscle dissection from the bony elements with removal of ligaments, tendons, and bony structures, which are all important parts of the dorsal stabilizing element of the spine . Because of the frequency of spinal surgery in dogs, interest in MISS has been growing . However, most studies are limited to dog cadavers; only two reports have described MISS thoracolumbar technique in live dogs .…”

Section: Introductionmentioning

confidence: 99%

“…Because of the frequency of spinal surgery in dogs, interest in MISS has been growing . However, most studies are limited to dog cadavers; only two reports have described MISS thoracolumbar technique in live dogs . As these studies have highlighted, there is a rationale for use of such techniques in the treatment of focal as well as multifocal intervertebral disc degenerative disorders (extrusion or protrusions).…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive spine surgery in dogs: Evaluation of the safety and feasibility of a thoracolumbar approach to the spinal cord

et al. 2020

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Objective To describe the safety and feasibility of a minimally invasive spine surgery technique to access the thoracolumbar vertebral canal in dogs. Study design Prospective study. Animals Six healthy research dogs. Methods Dogs were placed under anesthesia for MRI to evaluate vertebral column and spinal cord integrity. Minimally invasive surgery was performed at multiple sites. Access to the vertebral canal was achieved by means of foraminotomy, discectomy, and lateral minicorpectomy by using minimally invasive access and a surgical microscope. Sequential neurological examinations, pressure algometry pain quantification, and creatine kinase levels were evaluated before and after surgery for 7 days. Magnetic resonance imaging, computed tomography, and histopathology were performed on day 6 postoperatively after animals were humanely killed to evaluate the impact of surgery on spinal cord, muscles, and bone. Results The vertebral canal was successfully accessed, and the ventral aspect of the spinal cord was identified at all sites. No neurological deterioration was observed. Postoperative pain was not different compared with baseline except in one dog on the day after surgery. Conclusion Minimally invasive spine surgery was a safe and feasible technique to access the thoracolumbar vertebral canal and the ventral aspect of the spinal cord in dogs. Findings supported postoperative pain benefits. Clinical significance Minimally invasive spine surgery is a valid surgical technique to access the thoracolumbar vertebral canal at single or multiple sites in dogs.

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“…In fact, today's surgical trends point toward reducing the invasiveness of all surgeries. Minimally invasive surgery of the spine is now performed routinely in humans and has also been reported clinically and experimentally for the cervical and thoracolumbar regions in dogs . These studies rely either on percutaneous palpation or fluoroscopy to target the correct intervertebral disc space.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonography is more accurate than percutaneous palpation for identifying targeted thoracolumbar intervertebral disc spaces in dogs

Boursier¹,

Fournet

Bassanino³

et al. 2018

Vet Radiology Ultrasound

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During minimally invasive spinal surgery, correct identification of the affected intervertebral disc space is critical. Percutaneous palpation is commonly used, but results may be unreliable. Fluoroscopy is the gold standard but can be cumbersome and exposes operators to ionizing radiation. Spinal ultrasound has been described in veterinary medicine and could be a feasible alternative. This prospective, methods comparison study mimicked a minimally invasive spinal surgery in 10 canine cadavers and compared the accuracy of ultrasound and percutaneous palpation for thoracolumbar intervertebral disc space identification, using fluoroscopy as the reference standard. For each experiment, a disc space was randomly chosen. Identification was then attempted using both percutaneous palpation and ultrasound. For ultrasound, a linear probe was used to guide the operator to the correct location. The time necessary to perform each method was recorded. Accuracies for each method were calculated and statistically compared. Effects of body condition score, location of the targeted thoracolumbar intervertebral disc space and learning curve for each method were also evaluated. Ultrasonographic identification was more accurate (96.7% vs. 76.7%; P < 0.03) but took longer (147 s vs. 29 s; P < 0.0001) than percutaneous palpation. Findings from this cadaver study indicated that percutaneous palpation alone had low accuracy for correctly identifying a targeted thoracolumbar intervertebral disc space and supported the use of ultrasound as a method for improving the accuracy. Future studies are needed to assess the method in clinical cases, especially in obese dogs and/or those in which the targeted site is distant from palpable anatomical landmarks.

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Operative Techniques and Preliminary Outcomes Following Percutaneous Endoscopic Thoracolumbar Pediculectomy in Dogs

Abstract: Pediculectomy using a percutaneous endoscopic thoracolumbar lateral approach is feasible, provides a good view of the spinal canal, and may be an alternative for treatment of disk disease in dogs.

Cited by 13 publications

References 38 publications

Minimally invasive microsurgical decompression of an intervertebral disc protrusion in a dog

Minimally invasive microsurgical decompression of an intervertebral disc protrusion in a dog

Minimally invasive spine surgery in dogs: Evaluation of the safety and feasibility of a thoracolumbar approach to the spinal cord

Ultrasonography is more accurate than percutaneous palpation for identifying targeted thoracolumbar intervertebral disc spaces in dogs

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