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犬经皮内镜单通道半椎板切除术的手术技术

Operative techniques of percutaneous endoscopic mini-hemilaminectomy using a uniportal approach in dogs.

作者信息

Moon Hee-Sup, Hwang Yong-Hyun, Lee Hee-Chun, Lee Jae-Hoon

机构信息

Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju-si, 52828, South Korea.

出版信息

J Vet Med Sci. 2017 Sep 12;79(9):1532-1539. doi: 10.1292/jvms.17-0148. Epub 2017 Jul 31.

Abstract

The present study aimed to investigate the technical feasibility of percutaneous endoscopic mini-hemilaminectomy via a uniportal approach, and to evaluate the possibility of decompression and endoscopic examination of the thoracic and lumbar spinal canals in small dogs during such procedures. Fresh canine cadavers of mixed-breed dogs (n=7) were used in this study. Following injection of a barium and agarose mixture (BA-gel) to stimulate intervertebral disc herniation, percutaneous endoscopic mini-hemilaminectomy was performed using a lateral approach to the thoracic and lumbar vertebrae. BA-gel was removed to decompress the spinal cord using an elevator and rongeurs after mini-hemilaminectomy. Pre and post-operative computed tomography (CT) scans were obtained to evaluate surgical outcomes. Intra-operative complications, incision length, and procedure time were recorded. All procedures were completed with clear visualization of the spinal cord and floor of the spinal canal. The mean total operating time was 58.00 ± 18.06 min. Lengths of incision were under 1 cm in all dogs. Intra-operative complications included iatrogenic nerve root injuries caused by the micro-rongeur in two dogs. CT imaging revealed that removal of BA-gel resulted in sufficient spinal cord decompression. Our findings indicated that percutaneous endoscopic thoracolumbar mini-hemilaminectomy is feasible for spinal cord decompression and allows for adequate observation of the spinal canal. Thus, this technique may be an alternative surgical option for treatment of thoracolumbar disk disease in dogs.

摘要

本研究旨在探讨经单通道入路进行经皮内镜下微创半椎板切除术的技术可行性,并评估在此类手术过程中对小型犬胸腰椎管进行减压和内镜检查的可能性。本研究使用了7只杂种犬的新鲜尸体。在注射钡剂和琼脂糖混合物(BA凝胶)以模拟椎间盘突出后,采用胸腰椎外侧入路进行经皮内镜下微创半椎板切除术。微创半椎板切除术后,使用骨膜剥离子和咬骨钳去除BA凝胶以减压脊髓。术前和术后均进行计算机断层扫描(CT)以评估手术效果。记录术中并发症、切口长度和手术时间。所有手术均在清晰观察脊髓和椎管底部的情况下完成。平均总手术时间为58.00±18.06分钟。所有犬的切口长度均小于1厘米。术中并发症包括两只犬因微型咬骨钳导致的医源性神经根损伤。CT成像显示,去除BA凝胶后脊髓得到了充分减压。我们的研究结果表明,经皮内镜下胸腰椎微创半椎板切除术对于脊髓减压是可行的,并且能够对椎管进行充分观察。因此,该技术可能是治疗犬胸腰椎间盘疾病的一种替代性手术选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3e8/5627323/876c4f41149a/jvms-79-1532-g001.jpg

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