Dyall Barbara, Schmökel Hugo
Ryggcenter, Specialistdjursjukhuset Strömsholm, Strömsholm, Sweden.
Front Vet Sci. 2017 May 19;4:75. doi: 10.3389/fvets.2017.00075. eCollection 2017.
An approach using a complete cranial iliac osteotomy (CCIO) to access the lumbosacral (LS) foramen in dogs from lateral was developed using cadavers and applied in a clinical patient with degenerative lumbosacral stenosis (DLSS). The foraminal enlargement in the cadavers and the patient was documented on postoperative CT scans. The preoperative CT scan of the patient showed moderate cranial telescoping of the sacral roof and a moderate central disk protrusion, leading to moderate to severe compression of the cauda equina. In addition, there was lateral spondylosis with consequential stenosis of the right LS foramen. The right L7 nerve had lost its fat attenuation and appeared thickened. After a routine L7S1 dorsal laminectomy with a partial discectomy, a CCIO was performed, providing good access to the LS foramen and the adhesions around the proximal L7 nerve caudoventral to the foramen. The osteotomy was stabilized with a locking plate and a cerclage wire. The dog recovered well from the procedures and after 36 h, the dog walked normally and was discharged from the hospital. Eight and 16 weeks later, the signs of the DLSS had markedly improved. From these data, it can be concluded that the CCIO is a useful approach to the LS foramen and intervertebral disk in selected patients with DLSS, giving good access to the structures around the LS foramen.
利用尸体开发了一种从侧面进入犬腰骶（LS）孔的完全颅骨髂骨截骨术（CCIO）方法，并应用于一名患有退行性腰骶椎管狭窄（DLSS）的临床患者。术后CT扫描记录了尸体和患者的椎间孔扩大情况。该患者术前CT扫描显示骶骨顶部有中度颅骨 telescoping和中度中央椎间盘突出，导致马尾神经中度至重度受压。此外，存在侧方脊柱关节病并伴有右侧LS孔狭窄。右侧L7神经失去了脂肪衰减且显得增粗。在进行常规的L7S1椎板背侧切除术和部分椎间盘切除术之后，实施了CCIO，能够很好地进入LS孔以及孔尾腹侧近端L7神经周围的粘连部位。截骨术用锁定钢板和环扎钢丝固定。这只狗术后恢复良好，36小时后能够正常行走并出院。8周和16周后，DLSS的症状明显改善。从这些数据可以得出结论，对于选定的DLSS患者，CCIO是一种进入LS孔和椎间盘的有用方法，能够很好地进入LS孔周围的结构。
