Prophylactic Effect of Fenestration on the Recurrence of Thoracolumbar Intervertebral Disc Disease in Dogs

Abstract

This systematic review aimed to assess the effect of prophylactic fenestration (PF) on the recurrence of thoracolumbar (TL) intervertebral disc (IVD) disease in dogs. Three online databases were searched (Web of Science, MEDLINE via PubMed, SCOPUS), 115 relevant studies were thoroughly examined by the authors, 29 of which met the pre-defined inclusion criteria for this systematic review. Data about the initial treatment, the performance of PF, the incidence of recurrence, and the site of recurrence were extracted. Most of the studies were deemed to have serious to moderate risk of bias. Out of 5457 dogs, 1264 underwent prophylactic fenestration. A total of 504 cases of suspected or confirmed recurrence were recorded, in which 164 (32.54% of total recurrences and 11.02% of PF cases) were in dogs treated with PF. In order to perform quantitative analysis for the recurrence odds, we conducted a meta-analysis. Five studies were included that met the inclusion criteria. Despite a large number of relevant publications, the quality of the evidence they provide is low. This prevented us from reaching a definitive conclusion on the prophylactic effect of fenestration on recurrence in dogs surgically treated for TL IVDH.

Thoracolumbar Intervertebral Disk Extrusion in Dogs: Do Onset of Clinical Signs, Time of Surgery, and Neurological Grade Matter?

“…11,20,[35][36][37] However, its benefits remain controversial. 20,[38][39][40] In our population of dogs presented with a neurological grade between 0 and 3, performance of fenestration during surgery seemed to be associated with a faster return to ambulation (p ¼ 0.033). Fenestration would not be expected to directly influence time of recovery, but rather provide a prophylactic measure against possible recurrence.…”

Dorsal laminectomy for the treatment of lateralised cervical intervertebral disc extrusions in dogs—Prognosis and complications

“…Aikawa et al ( 27 ) suggested that at the level of the thoracolumbar spine, prophylactic fenestration seems to help decreasing the risk of future herniation in the treated intervertebral discs, also reducing the likelihood of need for a second surgery. Despite this, a systematic review by Pontikaki et al ( 28 ), failed to reach a conclusion on the value of prophylactic fenestration on the recurrence of dogs treated surgically for a thoracolumbar IVDE. The low quality of the available evidence on the topic was regarded as the cause for this question to remain unanswered.…”