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大型犬尸体上采用集成式内镜胸腰椎半椎板切除术获得手术暴露范围的测定

Determination of surgical exposure obtained with integrated endoscopic thoracolumbar hemilaminectomy in large-breed cadaveric dogs.

作者信息

Drury Adam G, Monnet Eric, Packer Rebecca A, Marolf Angela J

机构信息

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.

出版信息

Vet Surg. 2019 Jun;48(S1):O52-O58. doi: 10.1111/vsu.12968. Epub 2018 Oct 28.

Abstract

OBJECTIVE

To define boundaries of minimally invasive integrated endoscopic hemilaminectomy at 4 sites in the canine thoracolumbar spine.

STUDY DESIGN

Experimental, randomized cadaveric study.

ANIMALS

Six cadaver dogs that had been humanely euthanized for reasons unrelated to this study.

METHODS

Hemilaminectomy was performed with an integrated endoscopic system at T11-12, T12-13, L1-2, and L2-3, 1 at each site, on the left or right side of each dog. Each site was randomly assigned either a 19-mm or a 23-mm cannula. The entire procedure, including soft tissue dissection, was performed through the cannula. Afterward, spines were imaged by computed tomography (CT) to measure the cranial and caudal extent of the hemilaminectomy from the center of the disc space.

RESULTS

The mean ± SD cranial extent of the hemilaminectomy was 4.5 ± 1.4 mm for the 19-mm cannula and 5.6 ± 1.4 mm for the 23-mm cannulas (P = .0757). The caudal extent of the hemilaminectomy was 9.5 ± 2.2 mm for the 19-mm cannula and 10.3 ± 1.6 mm for the 23-mm cannula (P = .206). The mean length of the hemilaminectomy was 13.0 ± 1.5 mm for the 19-mm cannula and 15.0 ± 2.1 mm for the 23-mm cannula (P = .022).

CONCLUSION

Integrated endoscopic systems were reliably used to access the spinal canal within the range of the above measurements relative to the disc space as identified by CT or magnetic resonance imaging.

CLINICAL SIGNIFICANCE

Integrated endoscopy can be considered as an option in dogs with thoracolumbar disc extrusions or other pathology measuring within the parameters defined by this study. Access may be possible beyond the dimensions defined in this study with probing and repositioning.

摘要

目的

确定犬胸腰椎4个部位微创一体化内镜下半椎板切除术的边界。

研究设计

实验性、随机尸体研究。

动物

6只因与本研究无关的原因被人道安乐死的犬尸体。

方法

使用一体化内镜系统在T11-12、T12-13、L1-2和L2-3节段进行半椎板切除术,每只犬的每个部位选一侧,各部位随机分配使用19毫米或23毫米的套管。整个手术过程,包括软组织分离,均通过套管进行。术后,通过计算机断层扫描(CT)对脊柱成像,以测量从椎间盘间隙中心起半椎板切除术的头端和尾端范围。

结果

19毫米套管的半椎板切除术平均头端范围±标准差为4.5±1.4毫米,23毫米套管为5.6±1.4毫米(P = 0.0757)。19毫米套管的半椎板切除术尾端范围为9.5±2.2毫米,23毫米套管为10.3±1.6毫米(P = 0.206)。19毫米套管的半椎板切除术平均长度为13.0±1.5毫米,23毫米套管为15.0±2.1毫米(P = 0.022)。

结论

相对于CT或磁共振成像确定的椎间盘间隙,一体化内镜系统可可靠地用于在上述测量范围内进入椎管。

临床意义

对于胸腰椎间盘突出或其他在此研究定义参数范围内的病理情况的犬,一体化内镜检查可被视为一种选择。通过探查和重新定位,可能超出本研究定义的尺寸范围进行操作。

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