Guevar Julien, Olby Natasha
University of Wisconsin-Madison, School of Veterinary Medicine, Madison, Wisconsin.
North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina.
Vet Surg. 2020 Jun;49 Suppl 1:O86-O92. doi: 10.1111/vsu.13263. Epub 2019 Jun 24.
To report the successful treatment of intervertebral disc protrusion with minimally invasive microsurgery in a large breed dog.
Retrospective case report.
A 4-year-old, neutered male, German shepherd dog presented with chronic progressive ambulatory paraparesis and thoracolumbar pain; lumbar intervertebral disc protrusion and severe spinal cord compression at L2-L3 were diagnosed.
A minimally invasive approach was used to access the target surgical area by using a muscle splitting technique and retractors. Intraoperative fluoroscopy confirmed correct placement. Magnification and illumination through a surgical microscope were used (microsurgery) to perform the spinal cord decompression by means of a foraminotomy and lateral corpectomy.
Technically, the combination of fluoroscopy and muscle splitting approach offered adequate minimally invasive access. Microsurgery allowed for precise and efficient spinal cord decompression. Clinically, no immediate postoperative neurological deterioration was observed. Opioid usage was limited to 24 hours postoperatively. Focal muscle swelling was observed postoperatively for 2 days, and hospital stay was 3 days. At 7 weeks postoperatively, neurological examination results were normal, and postoperative MRI confirmed spinal cord decompression. No complications were reported.
The procedure was associated with a small incision, limited muscle trauma, early improvement of the neurological status, a short hospital stay, and limited postoperative pain.
This case provides evidence that minimally invasive microsurgery is an effective treatment for intervertebral disc protrusion in large breed dogs and may offer benefits regarding postoperative pain and functional recovery.
报告大型犬椎间盘突出症的微创显微手术成功治疗病例。
回顾性病例报告。
一只4岁去势雄性德国牧羊犬,出现慢性进行性行走性截瘫和胸腰椎疼痛;诊断为腰椎间盘突出症,L2-L3处严重脊髓受压。
采用微创方法,通过肌肉劈开技术和牵开器进入目标手术区域。术中透视确认放置正确。使用手术显微镜进行放大和照明(显微手术),通过椎间孔切开术和侧方椎体切除术进行脊髓减压。
从技术上讲,透视和肌肉劈开方法相结合提供了之足够的微创入路。显微手术实现了精确有效的脊髓减压。临床上,术后未观察到立即出现神经功能恶化。阿片类药物使用仅限于术后24小时。术后观察到局部肌肉肿胀2天,住院时间为3天。术后7周,神经检查结果正常,术后MRI证实脊髓减压。未报告并发症。
该手术切口小、肌肉创伤小、神经功能状态早期改善、住院时间短、术后疼痛有限。
本病例证明微创显微手术是大型犬椎间盘突出症的有效治疗方法,可能在术后疼痛和功能恢复方面具有优势。