Abstract
Early post-operative neurological deterioration is a well-known complication following dorsal cervical laminectomies and hemilaminectomies in dogs. This study aimed to evaluate potential risk factors for early post-operative neurological deterioration following these surgical procedures. Medical records of 100 dogs that had undergone a cervical dorsal laminectomy or hemilaminectomy between 2002 and 2014 were assessed retrospectively. Assessed variables included signalment, bodyweight, duration of clinical signs, neurological status before surgery, diagnosis, surgical site, type and extent of surgery and duration of procedure. Outcome measures were neurological status immediately following surgery and duration of hospitalisation. Univariate statistical analysis was performed to identify variables to be included in a multivariate model.Diagnoses included osseous associated cervical spondylomyelopathy (OACSM; n = 41), acute intervertebral disk extrusion (IVDE; 31), meningioma (11), spinal arachnoid diverticulum (10) and vertebral arch anomalies (7). Overall 54% (95% CI 45.25–64.75) of dogs were neurologically worse 48 h post-operatively. Multivariate statistical analysis identified four factors significantly related to early post-operative neurological outcome. Diagnoses of OACSM or meningioma were considered the strongest variables to predict early post-operative neurological deterioration, followed by higher (more severely affected) neurological grade before surgery and longer surgery time. This information can aid in the management of expectations of clinical staff and owners with dogs undergoing these surgical procedures.
Highlights
Dorsal decompressive surgery for the treatment of cervical spinal diseases is a wellestablished surgical approach (Sharp and Wheeler, 2005)
Disorders commonly treated by this approach include osseous associated cervical spondylomyelopathy (OACSM), intervertebral disc extrusions with lateralised or dorsally located disc material, vertebral arch anomalies, spinal arachnoid diverticula (SAD), or where multiple ventral intervertebral disc protrusions are present
This study indicates that overall 55% of patients undergoing dorsal cervical decompressive surgeries will experience early postoperative neurological deterioration, which may be interpreted as a consequence of its invasive nature
Summary
Dorsal decompressive surgery for the treatment of cervical spinal diseases is a wellestablished surgical approach (Sharp and Wheeler, 2005). Disorders commonly treated by this approach include osseous associated cervical spondylomyelopathy (OACSM), intervertebral disc extrusions with lateralised or dorsally located disc material, vertebral arch anomalies, spinal arachnoid diverticula (SAD), or where multiple ventral intervertebral disc protrusions are present Several reports have suggested that cervical dorsal laminectomy should be considered an invasive procedure with a high risk of postoperative morbidity, many complications and prolonged hospitalisation and recovery times Other complications include marked tissue disruption, intraoperative haemorrhage, prolonged surgery times, excessive scar tissue formation and cardiorespiratory compromise (de Risio et al, 2002; Delamide Gasper et al, 2014). Other studies have reported more favourable outcomes with limited hospitalisation and recovery times (Gill et al, 1996; Faissler, 2011, De Decker et al, 2012a)
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