Endoscopic-Assisted Lumbosacral Foraminotomy in the Dog

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Virginia Tech

Objective - To determine if an endoscopic-assisted foraminotomy significantly increases the area of the L7-S1 intervertebral foramen and if, over a 12-week time period, there is stenosis of the treated foramen.

Study Design - Prospective, experimental study

Animal Population - Six, clinically normal adult dogs.

Methods - Using endoscopic assistance a unilateral L7-S1 foraminotomy was performed. Computed tomography of the region was performed in the pre-operative, immediately post-operative and 12-week post-operative time periods. Parasagittal area measurements were obtained at the entry, middle and exit zones of the treatment and control foramen for each period. Objective and subjective data were compared among dogs, by time period and treatment status.

Results - Endoscopic assisted foraminotomy resulted in a significant increase in the mean parasagittal foramen area (mPFA) of the entry and middle zones in the immediate post-operative period. The exit zone was not made significantly larger at any time period. The foramen remained significantly larger at the 12-week post-operative period in the middle zone only. However, some decrease in the surgically created foramen enlargement occurred at all three levels. The dogs tolerated the procedure well, but did have a mild, temporary delay of functional return post-operatively.

Conclusions - Endoscopic assisted foraminotomy in the canine patient can be performed for certain regions of the foramen allowing enhanced visibility in the spinal canal during the procedure. The foramen can be surgically enlarged at the entry and middle zones using this technique. There is some reduction of the foraminal enlargement at 12-weeks post-operative. The clinical significance of this reduction is not evident from this study.

Clinical Relevance - Endoscopic assisted foraminotomy could be used to improve intra-operative visualization in dogs with foraminal stenosis as a component of degenerative lumbosacral stenosis.

Lumbosacral disease, Foraminal stenosis, Foraminotomy, Dogs