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

Ross C Elliott,Gareth Zeiler,Remo Lobetti,Chantel Moon

doi:10.4102/jsava.v91i0.2008

Abstract

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.

Highlights

Canine thoraco-lumbar intervertebral disc extrusion (IVDE) is a common condition presenting to the small animal veterinarian
236 dogs recovered from mini-hemilaminectomy across all the groups
It is widely accepted that decompressive surgery across all modified Frankel score (MFS) grades of thoraco-lumbar IVDE is an effective treatment in the majority of affected dogs (Langerhuus & Miles 2017)

Summary

Introduction

Canine thoraco-lumbar intervertebral disc extrusion (IVDE) is a common condition presenting to the small animal veterinarian. The most important prognostic indicator in IVDE is pelvic limb deep pain sensation (Griffin et al 2009; Levine et al 2009; Olby et al 2001). The MFS has shown to prognosticate the recovery in dogs with IVDE (Davis & Brown 2002; Griffin et al 2009; Ingram, Kale & Balfour 2013; Levine et al 2009; Skytte & Schmökel 2018). Dogs with no deep pain response (MFS 0) if operated on within the first 24 h of losing deep pain sensation have a 64% chance of having a successful outcome (Ingram et al 2013; Scott & McKee 1999; Skytte & Schmökel 2018)

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Conclusion