Harris Georgina, Freeman Paul
Department of Clinical Veterinary Medicine, Queens Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge, United Kingdom.
Vet Comp Orthop Traumatol. 2020 Jan;33(1):66-70. doi: 10.1055/s-0039-1700554. Epub 2019 Nov 22.
Intervertebral disc extrusion is a common disease affecting chondrodystrophic dogs. It has been reported that fenestration of thoracolumbar intervertebral discs reduces recurrence of disc extrusion and is associated with a low complication rate. One complication reported is iatrogenic introduction of disc material into the canal directly following fenestration. This study aimed to ascertain if, and at what frequency, additional disc material may be introduced into the vertebral canal by fenestration of the affected disc following decompressive surgery.
Twenty-one dogs that underwent hemilaminectomy and disc fenestration for the treatment of thoracolumbar intervertebral disc extrusion had intraoperative assessment of the vertebral canal before and after fenestration. The spinal cord was first decompressed by hemilaminectomy and removal of all visible extruded disc material within the vertebral canal. Once no further material was visible, manual fenestration of the affected disc was performed. The vertebral canal was re-inspected, and the presence or absence of additional material was noted and included in the surgery report.
Seven dogs showed the presence of new disc material in the vertebral canal post fenestration.This preliminary study shows that additional disc material can be forced into the vertebral canal by fenestration following decompressive surgery, with a frequency of 7/21.
This illustrates the importance of checking the vertebral canal after fenestration of an extruded intervertebral disc.
椎间盘突出是影响软骨发育不良犬的常见疾病。据报道，胸腰椎椎间盘开窗术可降低椎间盘突出的复发率，且并发症发生率较低。报道的一种并发症是开窗术后医源性地将椎间盘物质直接引入椎管。本研究旨在确定减压手术后对受影响椎间盘进行开窗时，是否会以及以何种频率将额外的椎间盘物质引入椎管。
21只接受半椎板切除术和椎间盘开窗术治疗胸腰椎椎间盘突出的犬，在开窗前后对椎管进行术中评估。首先通过半椎板切除术对脊髓进行减压，并清除椎管内所有可见的突出椎间盘物质。一旦看不到更多物质，对受影响的椎间盘进行手动开窗。再次检查椎管，记录是否存在额外物质，并纳入手术报告。
7只犬在开窗后椎管内出现新的椎间盘物质。这项初步研究表明，减压手术后开窗可将额外的椎间盘物质挤入椎管，频率为7/21。
这说明了对突出椎间盘进行开窗后检查椎管的重要性。
