A Modified Lateral Approach to the Canine Cervical Spine: Procedural Description and Clinical Application in 16 Dogs with Lateralized Compressive Myelopathy or Radiculopathy
To describe a modified lateral surgical approach to the cervical spine in dogs and evaluate clinical outcomes of dogs with neurologic disorders treated with this technique. Study Design
Retrospective study. Sample Population
Sixteen dogs with lesions involving the cervical spine. Methods
Medical records (1998–2002) of dogs that had a modified lateral approach to the cervical spine were reviewed. To reduce procedural morbidity, the surgical approach was modified from original descriptions of the technique by minimizing disruption of epaxial and extrinsic thoracic limb musculature and limiting the size of the operative field to the affected vertebral segment. Signalment, neurologic status on admission; onset, progression, and duration of clinical signs; diagnostic testing, etiologic diagnosis, surgical site(s), intra- and postoperative complications, hospitalization, time to optimum recovery, neurologic status at discharge, final neurologic status, and outcome were recorded. Neurologic status (0–5) was scored preoperatively, 1 day postoperatively, at discharge, and at recheck examination (8 dogs). Telephone interviews were used to obtain additional follow-up information. Results
None of the dogs had postoperative deterioration in neurologic status. Outcomes were good or excellent in dogs with intervertebral disc disease, 3/4 dogs with caudal cervical spondylomyelopathy, 1/2 dogs with spinal neoplasia, and in 1 dog with the vascular anomaly; long-term outcomes were unknown in 2 dogs. Intraoperative complications occurred in 3 dogs and included controllable venous plexus hemorrhage (2) and incorrect lesion localization (1). One dog was euthanatized because of postoperative complications. Hospitalization, time to optimal recovery, and overall outcome were not different from previously reported results using other surgical approaches to treat analogous neurologic conditions. Conclusions
A modified lateral approach to the cervical spine is viable for surgical treatment of cervical myelopathic or radiculopathic lesions when exposure to foraminal and lateralized lesions of the vertebral canal involving the C2–C7 vertebral articulations is desirable. Clinical Relevance
A modified lateral approach to the cervical spine can be successfully used in dogs of all sizes to treat caudal cervical spondylomyelopathy, other anomalous conditions of the cervical spine, intervertebral disc disease, and spinal neoplasms. Although long-term follow-up was not available for all patients, outcomes were generally favorable.
Document Type: Research Article
Affiliations: Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA.
Publication date: September 1, 2005