Abstract
ObjectivesTo assess feasibility of the harmonic Osteovue blade (HOB) for use in the soft tissue approach for dogs undergoing hemilaminectomy and to compare outcomes between dogs undergoing HOB or traditional approach (TRAD).MethodsA prospective randomized clinical trial was performed using 20 client-owned dogs with thoracolumbar intervertebral disk extrusion requiring hemilaminectomy. Dogs were randomly assigned to HOB or TRAD. Neurologic function and pain scores were assessed pre-operatively. Intraoperative blood loss and surgical approach time as well as postoperative pain and wound healing scores were recorded. Additionally, neurologic recovery and owner perceived quality of life were recorded at day 10 and 30 postoperative.ResultsThere was no significant difference in sex distribution, weight, age, preoperative neurological grade and pain score, and perioperative outcome measures between groups. Intraoperative total blood loss was minimal for HOB and TRAD (median: 0 ml (range 0–9) and 2.2 ml (range 0–6.8), respectively; p = 0.165) and approach times were similar (median: 7 min (range 5–12) and 8 min (range 5–13), respectively; p = 0.315). While changes in wound healing scores were similar, changes in postoperative pain scores and neurological function were significantly improved in the HOB compared to the TRAD group. Postoperative complications in the HOB group consisted of automutilation of part of the incision and development of a small soft, non-painful subcutaneous swelling in 1 dog each.ConclusionsThe HOB is a safe and effective tool for the soft tissue approach for routine spinal surgery in dogs and is associated with decreased pain and increased neurological function post-surgery.
Highlights
Laminectomies are among the most common procedures performed in canine neurosurgery
Soft tissue dissection during the surgical approach is similar to that used in human spine surgery, traditionally incorporating a mixture of sharp dissection with scalpel blade or scissors, blunt dissection with periosteal elevators, and electrocautery
Clinical studies on a variety of human soft tissue and orthopedic surgical procedures support the efficacy of ultrasonic surgical blades to reduce surgical time and decrease blood loss compared to electrocautery [19,20,21,22,23,24]
Summary
Soft tissue dissection during the surgical approach is similar to that used in human spine surgery, traditionally incorporating a mixture of sharp dissection with scalpel blade or scissors, blunt dissection with periosteal elevators, and electrocautery [1] While bleeding during the approach to the canine spine is rarely severe enough to require blood transfusions, even small bleeds can slow down surgery and impair visualization during subsequent decompression, potentially impacting clinical outcomes. Clinical studies on a variety of human soft tissue and orthopedic surgical procedures support the efficacy of ultrasonic surgical blades to reduce surgical time and decrease blood loss compared to electrocautery [19,20,21,22,23,24]
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