Residual Spinal Cord Compression Following Hemilaminectomy and Mini-Hemilaminectomy in Dogs: A Prospective Randomized Study

Svensson, Gustaf; Simonsson, Ulrika S. H.; Danielsson, Fredrik; Schwarz, Tobias

doi:10.3389/fvets.2017.00042

Cited by 12 publications

(11 citation statements)

References 22 publications

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“…Few studies provide direct comparisons of 1 surgical technique to another. 13,[81][82][83][84] Descriptions of the various techniques and their associated benefits and complications have been summarized previously. 85 In addition, several authors recently have reported minimally invasive techniques to address intervertebral disc herniation in dogs.…”

Section: Surgerymentioning

confidence: 99%

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

Moore

Olby

Brisson³

et al. 2022

Veterinary Internal Medicne

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Background Thoracolumbar intervertebral disc extrusion (TL‐IVDE) is the most common cause of acute paraparesis and paraplegia in dogs; however, guidelines on management of the condition are lacking. Objectives To summarize the current literature as it relates to diagnosis and management of acute TL‐IVDE in dogs, and to formulate clinically relevant evidence‐based recommendations. Animals None. Methods A panel of 8 experts was convened to assess and summarize evidence from the peer‐reviewed literature in order to develop consensus clinical recommendations. Level of evidence available to support each recommendation was assessed and reported. Results The majority of available literature described observational studies. Most recommendations made by the panel were supported by a low or moderate level of evidence, and several areas of high need for further study were identified. These include better understanding of the ideal timing for surgical decompression, expected surgical vs medical outcomes for more mildly affected dogs, impact of durotomy on locomotor outcome and development of progressive myelomalacia, and refining of postoperative care, and genetic and preventative care studies. Conclusions and Clinical Importance Future efforts should build on current recommendations by conducting prospective studies and randomized controlled trials, where possible, to address identified gaps in knowledge and to develop cost effectiveness and number needed to treat studies supporting various aspects of diagnosis and treatment of TL‐IVDE.

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Section: Surgerymentioning

confidence: 99%

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

Moore

Olby

Brisson³

et al. 2022

Veterinary Internal Medicne

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“…Bei chronischem thorakolumbalem BSV kann auch eine laterale Korpektomie in Betracht gezogen werden, die im Vergleich zur Hemilaminektomie das Risiko iatrogener Rückenmarksschädigung und Sinusblutung minimiert [17], deren Erfolg allerdings stärker von der Erfahrung des Operateurs abhängt [24]. Die Minihemilaminektomie stellt durch ihre geringe Invasivität eine weitere schonende Methode dar, die eine erheblich stärkere Dekompression für das Rückenmark schafft als die Hemilaminektomie [32]. Im Fall zervikaler BSV ist der ventrale Slot aufgrund der schnellen Durchführbarkeit die Methode der Wahl und findet am häufigsten Anwendung [30] [33].…”

Section: Einleitung Und Zielsetzungunclassified

“…Dies steht konträr zum Ergebnis der Studie von Bull et al [8], die bei größeren Hunden eine längere Rekonvaleszenzzeit feststellten als bei kleineren Hunden. [32]. Eine erhöhte Rezidiv rate konnte weder in Abhängigkeit von den Rassengruppen noch den unterschiedlichen Gewichtsklassen nachgewiesen werden.…”

Section: Auswertung Postoperativer Datenunclassified

Postoperatives Ergebnis bei Diskopathien des Hundes in Abhängigkeit von Rasse, Lokalisation und Erfahrung des Chirurgen: 1113 Fälle

Klesty¹,

Forterre

Bolln³

2019

Tierarztl Prax Ausg K

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Zusammenfassung Gegenstand und Ziel Der Bandscheibenvorfall (BSV) ist eine häufige neurologische Erkrankung bei Hunden, der in vielen Fällen chirurgisch behandelt werden kann. Retrospektiv sollten bei solchen Patienten mögliche Einflussfaktoren wie Signalement, Lokalisation oder Schweregrad des BSV sowie Erfahrung des Operateurs auf das langfristige Behandlungsergebnis eruiert werden. Material und Methoden Die Auswertung umfasste die Daten von 1113 Hunden, die von Januar 2008 bis Juli 2013 an einem oder mehreren Bandscheibenvorfällen operiert worden waren. Ergebnisse Hunde chondrodystropher (CD) Rassen mit einer Disposition wie Dackel, Jack Russell Terrier und Französische Bulldogge erkrankten deutlich früher an BSV als Hunde nicht chondrodystropher (NCD) Rassen mit signifikanten rassespezifischen Unterschieden hinsichtlich Lokalisation und neurologischem Schweregrad. Intakte Rüden waren überproportional häufiger betroffen, während das Gewicht der Patienten nicht mit dem Auftreten eines BSV korrelierte. Der neurologische Schweregrad und die Lokalisation des BSV, nicht aber die Hunderasse oder der Erfahrungsgrad des Operateurs beeinflussten das postoperative Behandlungsergebnis. Schlussfolgerung und klinische Relevanz CD-Rassen erkrankten häufiger an einem BSV als NCD-Rassen mit Französischen Bulldoggen als jüngsten Patienten. Die meisten Vorfälle traten in der BWS (Peak in Th12/13) auf, die wenigsten in der HWS mit rassespezifischen Unterschieden: Beagle erkrankten vorwiegend in der HWS, Hunde kleiner NCD-Rassen, Dackel und Jack Russell Terrier in der BWS und Französische Bulldoggen sowie Hunde großer NCD-Rassen in der LWS. Ungünstig für das klinische Behandlungsresultat waren ein höherer neurologischer Schweregrad und ein BSV in der BWS: Kleine NCD mit BSV Grad IV in der BWS hatten die längste Rekonvaleszenz, während Französische Bulldoggen mit dem selben Grad in der LWS schneller wieder lauffähig waren.

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“…A mini-hemilaminectomy (Images 1 and 2), however, preserves the articular facet joint and only removes the pedicle, described as for a hemilaminectomy ventral to the articular facet (Lubbe, Kirberger & Verstraele 1994 ). Studies have observed residual spinal cord compression post-operatively when a mini-hemilaminectomy was compared with a hemilaminectomy (Huska et al 2014 ; Svensson et al 2017 ). A recent study has however contraindicated this by indicating less residual disc material with a mini-hemilaminectomy compared with a hemilaminectomy (Svensson et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

“…Studies have observed residual spinal cord compression postoperatively when a mini-hemilaminectomy was compared with a hemilaminectomy (Huska et al 2014;Svensson et al 2017). A recent study has however contraindicated this by indicating less residual disc material with a minihemilaminectomy compared with a hemilaminectomy (Svensson et al 2017). Hemilaminectomy has however been shown in mechanical studies to increase the range of motion of the vertebral column by 11%; this has been put forward as a cause of instability in dogs recovering from decompressive surgery of the spinal cord (Hill, Lubbe & Guthrie 2000).…”

Section: Introductionmentioning

confidence: 99%

Short-term clinical outcomes of 220 dogs with thoraco-lumbar disc disease treated by mini-hemilaminectomy

Elliott

Moon

Zeiler

et al. 2020

J. S. Afr. Vet. Assoc.

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Thoraco-lumbar intervertebral disc extrusion is a common condition seen in veterinary practice. Although there are different surgical techniques described for decompression, most of these techniques are based on the surgeon’s preference or experience rather than clinical research. Our objective was to determine the clinical outcomes, using return to ambulation and micturition, as well as complication rates, in a large cohort of dogs by using a mini-hemilaminectomy for decompression of the thoraco-lumbar spinal cord with Hansen type I thoraco-lumbar intervertebral disc extrusions (IVDE). A retrospective study was performed on dogs presented for acute thoraco-lumbar IVDE undergoing surgical decompression. In total, 252 spinal decompression surgeries were performed. The recovery rates for patients graded with a modified Frankel score (MFS) of 5 to 0 were 100%, 99%, 100%, 96%, 86% and 64%, respectively. The mean days to micturition across all the MFS 5–0 were 1.5 (standard deviation [SD] ± 0.7), 1.8 (SD ± 1), 4.3 (SD ± 1.7), 6.4 (SD ± 2.2), 9.3 (SD 3) and 11.9 (SD ± 2.2), respectively. The mean days to ambulation across all the groups 5–0 were 2 (SD ± 0.7), 2.6 (SD ± 1), 7.6 (SD ± 4.4), 10.1 (SD ± 2.5), 16.1 (SD ± 2.9) and 19.3 (SD ± 2.6), respectively. Postoperative complications were seen in 32 of the surgeries, with a complication rate of 13%. Minor complications accounted for 38% of all complications, and major complications constituted 62% of all complications. In total, 15 dogs died or were euthanised as a direct result of thoraco-lumbar disc extrusion or the surgical procedure, with a mortality rate of 6% across all groups. A mini-hemilaminectomy provides similar clinical outcomes described in the literature for other methods of spinal cord decompressive surgery, and it also provides patients with similar short-term outcomes to other described decompressive surgical techniques in the dog, which have been described in the literature.

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Residual Spinal Cord Compression Following Hemilaminectomy and Mini-Hemilaminectomy in Dogs: A Prospective Randomized Study

Cited by 12 publications

References 22 publications

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

Postoperatives Ergebnis bei Diskopathien des Hundes in Abhängigkeit von Rasse, Lokalisation und Erfahrung des Chirurgen: 1113 Fälle

Short-term clinical outcomes of 220 dogs with thoraco-lumbar disc disease treated by mini-hemilaminectomy

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