Medium-Term Outcome and CT Assessment of Lateral Foraminotomy at the Lumbosacral Junction in Dogs with Degenerative Lumbosacral Stenosis.

Abstract

This article aims to report the medium-term clinical outcome and assess persistence of enlargement of the lumbosacral lateral intervertebral neurovascular foramen using computed tomography (CT) volumetric analysis in dogs following lateral foraminotomy. Six dogs that underwent lumbosacral lateral foraminotomy on one or both sides were evaluated with CT prior to, immediately postoperatively (n = 2) and at 12 to 44 months of follow-up. Five out of six dogs had successful clinical outcomes with alleviation of pain and increased levels of activity, according to subjective assessment. Immediate postoperative CT volumetric analysis of the lateral intervertebral neurovascular foramina in two dogs indicated a 650 to 800% increase in volume in extension achieved by foraminotomy (four foramens). At subsequent follow-up, bone regrowth had occurred with reduction in foraminal volume, though in both dogs foraminal volume remained higher than preoperative values. Follow-up CT at a median of 24 months postoperatively indicated a mean 335% increase in volume of the lumbosacral lateral intervertebral neurovascular foramina in extension compared with the preoperative foraminal volume. The follow-up volume was substantially greater than the presurgical volume in four out of six dogs. In this limited case series, lateral foraminotomy achieved persistent enlargement of the lumbosacral lateral intervertebral neurovascular foramen in the medium term, but osseous regrowth at the site was demonstrated which may limit the effectiveness of lateral foraminotomy in the longer term. One of two working dogs had recurrent clinical signs that necessitated further surgery.