Korean Journal of Veterinary Service (한국동물위생학회지)

The Korean Society of Veterinary Service (한국동물위생학회)
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Minimally invasive percutaneous endoscopic thoracolumbar foraminotomy in large-breed dogs-a comparative study

  • Soo Hee Lee (Department of Veterinary Surgery, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University) ;
  • Soo Young Choi (Department of Veterinary Medical Imaging, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University) ;
  • Ho Hyun Kwak (Department of Veterinary Surgery, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University) ;
  • Heung Myong Woo (Department of Veterinary Surgery, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University)
  • Received : 2024.06.07
  • Accepted : 2024.06.12
  • Published : 2024.06.30
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Abstract

This study aimed to evaluate the feasibility of percutaneous endoscopic foraminotomy (PEF) for the treatment of intervertebral disc herniation of the thoracolumbar spine in large-breed dogs by comparing it with open hemilaminectomy (OH). Six large-breed canine cadavers were used in the present study. A barium and agarose mixture (BA-gel) simulating intervertebral disc herniation was injected into the spinal canal at two intervertebral spaces (T12-T13, L2-L3) of the thoracolumbar spine in each cadaver. PEF and OH were randomly allocated to the sites in each cadaver. Computed tomography was performed pre- and postoperatively. The incision length, vertebral window size, procedure time, and amount of simulated disc material removed were recorded to compare PEF and OH. Both procedures clearly exposed the simulated disc material and spinal cord. The size of the incision and vertebral window created after PEF was much smaller than those after OH. The surgical duration of PEF was longer than that of OH. However, no significant difference (P>0.05) was observed in the amount of BA-gel removed between PEF and OH. Thus, PEF could be used as an effective surgical option for intervertebral disc herniation of the thoracolumbar region in large-breed dogs in that it could lead to less tissue damage as well as sufficient removal of the simulated disc material.

Keywords

Acknowledgement

The authors would like to thank Richard Wolf GmbH for providing their instrumental support.

References

  1. Ahn Y. 2021. A historical review of endoscopic spinal discectomy. World Neurosurgery ; 145: 591-596.
  2. Bergknut N, Egenvall A, Hagman R, Gusts P, Hazewinkel HA et al. 2012. Incidence of intervertebral disk degeneration-related diseases and associated mortality rates in dogs. J American Veterinary Medical Association ; 240(11): 1300-1309.
  3. Besalti O, Pekcan Z, Sirin YS, Erbas G. 2006. Magnetic resonance imaging findings in dogs with thoracolumbar intervertebral disk disease: 69 cases (1997-2005). J American Veterinary Medical Association ; 228(6): 902-908.
  4. Brisson BA. 2010. Intervertebral disc disease in dogs. The Veterinary Clinics of North America Small Animal Practice ; 40(5): 829-858.
  5. Corse MR, Renberg WC, Friis EA. 2003. In vitro evaluation of biomechanical effects of multiple hemilaminectomies on the canine lumbar vertebral column. American Journal of Veterinary Research ; 64(9): 1139-1145.
  6. Cudia SP, Duval JM. 1997. Thoracolumbar intervertebral disk disease in large, nonchondrodystrophic dogs: A retrospective study. J American Animal Hospital Association ; 33(5): 456-460.
  7. Daghighi MH, Pouriesa M, Maleki M, Fouladi DF, Pezeshki MZ et al. 2014. Migration patterns of herniated disc fragments: a study on 1,020 patients with extruded lumbar disc herniation. The Spine Journal ; 14(9): 1970-1977.
  8. Gomes SA, Volk HA, Packer RM, Kenny PJ, Beltran E et al. 2016. Clinical and magnetic resonance imaging characteristics of thoracolumbar intervertebral disk extrusions and protrusions in large breed dogs. Veterinary Radiology & Ultrasound ; 57(4): 417-426.
  9. Guevar J, Zidan N, Durand A, Olby NJ. 2020. Minimally invasive spine surgery in dogs: Evaluation of the safety and feasibility of a thoracolumbar approach to the spinal cord. Veterinary surgery ; 49 Suppl 1: O76-O85.
  10. Hettlich BF. 2018. Minimally invasive spine surgery in small animals. The Veterinary Clinics of North America: Small Animal Practice ; 48(1): 153-168.
  11. Hijikata SA. 1975. A method of percutaneous nuclear extraction. Journal of Toden Hospital ; 5: 39.
  12. Huska JL, Gaitero L, Brisson BA, Nykamp S, Thomason J, Sears WC. 2014. Comparison of the access window created by hemilaminectomy and mini-hemilaminectomy in the thoracolumbar vertebral canal using computed tomography. The Canadian Veterinary Journal ; 55(5): 449-455.
  13. Hwang YH, Lee HC, Lee JH. 2016. Operative techniques and preliminary outcomes following percutaneous endoscopic thoracolumbar pediculectomy in dogs. Veterinary Surgery ; 45(S1): O84-O94.
  14. Lee DY, Lee SH. 2008. Learning curve for percutaneous endoscopic lumbar discectomy. Neurologia Medico-chirurgica ; 48(9): 383-8; discussion 388-9.
  15. Lockwood AA, Griffon DJ, Gordon-Evans W, Matheson JA, Barthlmy N, Schaeffer DJ. 2014. Comparison of two minimally invasive approaches to the thoracolumbar spinal canal in dogs. Veterinary Surgery ; 43(2): 209-221.
  16. Macias C, Mckee WM, May C, Innes JF. 2002. Thoracolumbar disc disease in large dogs: a study of 99 cases. J Small Animal Practice ; 43(10): 439-446.
  17. Mateo I, Lorenzo V, Foradada L, Munoz A. 2011. Clinical, pathologic, and magnetic resonance imaging characteristics of canine disc extrusion accompanied by epidural hemorrhage or inflammation. Veterinary Radiology & Ultrasound ; 52(1): 17-24.
  18. Moon HS, Hwang YH, Lee HC, Lee JH. 2017. Operative techniques of percutaneous endoscopic mini-hemilaminectomy using a uniportal approach in dogs. J Veterinary Medical Science ; 79(9): 1532-1539.
  19. Moore SA, Early PJ, Hettlich BF. 2016. Practice patterns in the management of acute intervertebral disc herniation in dogs. J Small Animal Practice ; 57(8): 409-415.
  20. Muthu S, Ramakrishnan E, Chellamuthu G. 2021. Is endoscopic discectomy the next gold standard in the management of lumbar disc disease Systematic review and superiority analysis. Global Spine Journal ; 11(7): 1104-1120.
  21. Nakamura S, Taguchi M. 2019. A new percutaneous endoscopic instrument for far-migrated disk herniation: A retrospective single-institution study. Journal of Neurological Surgery. Part A, Central European Neurosurgery ; 80(6): 488-493.
  22. Olby N, Levine J, Harris T, Muana K, Skeen T, Sharp N. 2003. Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001). J American Veterinary Medical Association ; 222(6): 762-769.
  23. Postacchini F, Postacchini R. 2011. Operative management of lumbar disc herniation : the evolution of knowledge and surgical techniques in the last century. Acta neurochirurgica. 108: 17-21.
  24. Qin R, Liu B, Hao J, Zhou P, Yao Y et al. 2018. Percutaneous endoscopic lumbar discectomy versus posterior open lumbar microdiscectomy for the treatment of symptomatic lumbar disc herniation: A systemic review and meta-analysis. World Neurosurgery ; 120: 352-362.
  25. Roach WJ, Thomas M, Weh JM, Bleedorn J, Wells K. 2012. Residual herniated disc material following hemilaminectomy in chondrodystrophic dogs with thoracolumbar intervertebral disc disease. Veterinary and Comparative Orthopaedics and Traumatology ; 25(2): 109-115.
  26. Sharp NJH, Wheeler SJ. 2005. Thoracolumbar disc disease. In: Small Animal Spinal Disorders Diagnosis and Surgery. 2nd ed. pp.121-159.
  27. Shi R, Wang F, Hong X, Wang YT, Bao JP et al. 2019. Comparison of percutaneous endoscopic lumbar discectomy versus microendoscopic discectomy for the treatment of lumbar disc herniation: a meta-analysis. International Orthopaedics ; 43(4): 923-937.
  28. Shores A. 2017. Thoracolumbar hemilaminectomy. In: Brisson BA (editor). Current techniques in canine and feline neurosurgery. 1st ed. Hoboken, NJ, USA: John Wiley & Sons; pp. 179-182.
  29. Truumees E. 2015. A history of lumbar disc herniation from Hippocrates to the 1990s. Clinical Orthopaedics and Related Research ; 473(6): 1885-1895.
  30. Vicente F, Bernard F, FitzPatrick D, Moissonnier P. 2013. In vitro radiographic characteristics and biomechanical properties of the canine lumbar vertebral motion unit after lateral corpectomy, mini-hemilaminectomy and hemilaminectomy. Veterinary and Comparative Orthopaedics and Traumatology ; 26(1): 19-26.
  31. Viguier E, Petit-Etienne G, Magnier J, Diop A, Lavaste F. 2002. Mobility of T13-L1 after spinal cord decompression procedures in dogs (an in vitro study). Veterinary Surgery. ; 31: 297.
  32. Woelfel CW, Robertson JB, Mariani CL, Munana KR, Early PJ, Olby NJ. Outcomes and prognostic indicators in 59 paraplegic medium to large breed dogs with extensive epidural hemorrhage secondary to thoracolumbar disc extrusion. Veterinary Surgery 2021; 50(3): 527-536.
  33. Wu X, Fan G, Guan X, Zhu Y, Huang L et al. 2016. Percutaneous endoscopic lumbar discectomy for farmigrated disc herniation through two working channels. Pain Physician ; 19(4): E675-E680.
  34. Yang S, Moon H, Hwang Y, Lee H, Lee D et al. 2021. Percutaneous endoscopic limited-lumbosacral-dorsal laminectomy in eight dogs - A cadaveric study. Veterinerny Medicina ; 66(7): 279-286.