Comparison of hemilaminectomy and dorsal laminectomy for thoracolumbar intervertebral disc extrusion in dachshunds

Abstract

Neurological improvement after decompressive surgery, without routine therapeutic or prophylactic disc fenestration, was evaluated retrospectively in a consecutive series of 93 dachshunds with thoracolumbar disc extrusion. In 24 per cent of procedures, deep pain sensation was not elicited in at least one hind paw before surgery. Median neurological status one to seven days after surgery, at the time of discharge, was significantly improved after hemilaminectomy compared with dorsal laminectomy (P < 0.05). After hemilaminectomy, deep pain sensation was not elicited in one or both hind paws of 8 per cent of dogs in which pain sensation was elicited before surgery, compared with 21 per cent after dorsal laminectomy (P > 0.05). Improvement in neurological grade at follow-up examination two to 12 weeks after hemilaminectomy was not significantly different compared with dorsal laminectomy (P > 0.05). Of dogs which were unable to walk before surgery, 83 per cent regained the ability to walk after hemilaminectomy, compared with 74 per cent after dorsal laminectomy (P > 0.05). In both groups, 50 per cent of dogs in which deep pain sensation was abnormal before surgery eventually regained the ability to walk after surgery (P = 1). One to two years after the first operation, a second laminectomy was performed in only 5 per cent of dogs because of extrusion of a different intervertebral disc which had not been fenestrated.

Clinical Aspects of Surgical Treatment of Thoracolumbar Disc Disease in Dogs. A Retrospective Study of 300 Cases

“…To our knowledge, there are few reports in the literature on the recurrence rate of disc disease only due to herniation of other disc in thoracolumbar region of spine after decompressive surgery without prophylactic fenestration. In only 5% of dogs was a second laminectomy performed, one to two years after the first surgery, because of extrusion of a different intervertebral disc which had not been fenestrated at the time of the first decompressive operation (Muir et al 1995). Our previous retrospective study of results of surgical treatment of the thoracolumbar disc disease in 90 patients, including prophylactic fenestration alone in twelve dogs with grade II paraparesis, and hemilaminectomy without fenestration of other discs in seventy-eight dogs with grades III, IV A and IV B, respectively, showed only 1.5% recurrence rate (Neãas 1995b).…”

“…We did not perform routine prophylactic fenestrations of the high risk disc spaces of the thoracolumbar region because of the reported low incidence of subsequent disc herniations another site (Muir et al 1995;Neãas 1995b;Prata 1981), the variable efficacy of fenestration related to the amount of nuclear material actually removed (Shores et al 1985), and extended time of surgery, respectively. We used autogenous fat grafts, which have been advocated to prevent scar formation and invasion of the vertebral canal (Kiviluoto 1976).…”

Clinical presentation and outcome of dogs treated medically or surgically for thoracolumbar intervertebral disc protrusion

“…Affected dogs typically demonstrate a chronic onset of progressive, but relatively mild clinical signs, such as spinal hyperaesthesia, ambulatory paraparesis and proprioceptive ataxia (Hansen 1951, 1959, Smolders and others 2013). Numerous studies have evaluated IVDE and this type of intervertebral disc disease is well characterised, with outcomes after medical and surgical management extensively reported (Muir and others 1995, Davis and Brown 2002, Ferreira and others 2002, Olby and others 2004, Aikawa and others 2012, Steffen and others 2014). However, very few studies have investigated the clinical characteristics of IVDP, and hence there is little information available to facilitate clinical decision-making and management of client expectations.…”

Recuperação funcional de cães paraplégicos com doença do disco intervertebral toracolombar sem percepção à dor profunda submetidos ao tratamento cirúrgico: 15 casos (2006-2010)

“…De acordo com Muir et al (1995), apenas 5% dos cães no qual são empregadas estas técnicas apresentam recorrência. Diante disso, a fenestração do disco afetado após a hemilaminectomia é recomendada e pode ser efetiva na prevenção de novas extrusões.…”