2015 ACVIM Forum Research Abstract Program

Surgical technique: We used Karl Storz endoscopic equipment and Karl Storz neurosurgical system EasyGo to perform the surgery. Needle was placed near the spinal process to mark correct intervertebral space and placement was confirmed with a lateral view X-ray. Patient was placed in ventral recumbency and surgical field was aseptically prepared. After confirmation of the disc space, we made 19 or 23 mm skin incision, located spinal process of the vertebrae and removed it with Luer Rongeur. Puncture needle was installed at 45 degree to the base of removed spinal process and then sequential dilators are used for bloodless access to the bone. After surgical field is exposed, we installed a throacar with 360 degree rotating head. The throacar and the rotating head are used allow endoscope movement down to the spinal canal for the surgical field visualization. From this point on, the surgery is guided by continuous endoscopic vision. Remnant muscle tissues are removed with forceps and bleeding is stopped with bipolar electrocautery. Shaver is used for drilling the bone, with irrigator and suction used to remove bone particles. Kerrison's rounger is used to widen the entrance into the spinal canal. Extruded disc material is grasped with a forceps and removed from the spinal canal. Spinal cord is evaluated via endoscopic visualization. Two adjacent disc spaces were fenestrated before closure of the surgical wound. All dogs became ambulatory after surgery, 9 dogs return to normal gait between day 2 and day 9 post operatively. At 3 months follow up 12 patients did not have any neurological deficits. Described technique provides great benefits for the surgeon as well as for the patient. In comparison to standard hemilaminectomy, 16 fold magnification allows superior visualization of the surgical field and spinal cord and nerve roots. Improved differentiation of the anatomic structures results in gentler manipulation of the nervous structures and reduces risks of bleeding. Two adjacent disc spaces can be fenestrated via the same incision. Dilation system and smaller incision reduce muscle trauma and postsurgical pain. Owners are very pleased to see a smaller incision.