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Vet Comp Orthop Traumatol 2021; 34(06): 427-436
DOI: 10.1055/s-0041-1735647
Clinical Communication

Distraction Stabilization of Degenerative Lumbosacral Stenosis: Technique and Mid- to Long-Term Outcome in 30 Cases

Philip R. Inness 
1   University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, University of Sydney, NSW, 2006, Australia
,
Tiffany L. Kimbrell 
2   United States Army Veterinary Medical Corps, Washington, Dist. of Columbia, United States
,
Sarah Nemanic
3   Veterinary Radiology Consulting, Lebanon, Oregon, United States
,
Wendy I. Baltzer
1   University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, University of Sydney, NSW, 2006, Australia
› Author Affiliations Funding The study was funded by the Department of Clinical Sciences Internal Grant, Oregon State University.
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Abstract

Objective To describe the dorsal laminectomy, annulectomy and distraction stabilization with pins and polymethylmethacrylate technique, its complications and outcome in the management of canine degenerative lumbosacral stenosis. To determine pre- and post-surgical foraminal width and vertebral step changes.

Study Design Multi-institutional retrospective clinical study.

Methods Medical records (2005–2020) of dogs treated (n = 30). Clinical signs, Modified Frankel Score, Texas Spinal Cord Injury Score, pain score (dorsal palpation of spine, tail dorsiflexion), imaging findings and complications were retrieved pre-operatively, perioperatively and at long-term follow-up.

Results The most common presurgical imaging findings were disc protrusion (24/25) and sclerosis of the caudal end-plate of L7 (23/30). On short- to long-term assessment 18 out of 21 dogs exhibited clinical improvement and all exhibited improved pain scores (p < 0.0001). Catastrophic complications occurred in 3 dogs, and major complications occurred in 5, of which 3 required additional surgery. Mean lumbosacral step defect reduced 60% (1.8 mm ± 2.5 mm pre-surgery to 0.7mm ± 0.9mm post-surgery, p = 0.1585). Mean foraminal width significantly increased 50% long-term (3.3 mm ± 1.0 mm pre-surgery to 5.0 mm ± 0.9 mm post-surgery, p < 0.0001).

Clinical Significance Dorsal laminectomy, annulectomy and distraction stabilization is a complex procedure which can significantly increase foraminal width, reduce pain and improve gait characteristics in dogs in the short- to long-term, and should be performed by surgeons experienced in lumbosacral pin placement.

Keywords

lumbosacral stenosis - distraction - canine - polymethylmethacrylate

Authors' Contributions

P.R.I.: Collation and analysis of the multi-institution data and preparation of the final manuscript. T.L.K.: Initial collection and analysis of data and manuscript preparation. S.N.: Initial imaging assessment. W.I.B.: Primary surgeon and designer of the technique and statistical analysis, preparation and approval of the final manuscript.




Publication History

Received: 19 March 2021

Accepted: 06 August 2021

Article published online:
01 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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