Editorial Type:
Neurology

Evaluation of epiduroscopy for detection of vertebral canal and spinal cord lesions in dogs

Fernando L. Garcia-Pereira Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.

Search for other papers by Fernando L. Garcia-Pereira in
Current site
Google Scholar
PubMed Close
 DVM, MS
,
Timo Prange Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh NC 27607.

Search for other papers by Timo Prange in
Current site
Google Scholar
PubMed Close
 DVM, MS
,
Aaron Seller Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL 32610.

Search for other papers by Aaron Seller in
Current site
Google Scholar
PubMed Close
 DO
, and
Victoria Obert Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.

Search for other papers by Victoria Obert in
Current site
Google Scholar
PubMed Close
DOI:
https://doi.org/10.2460/ajvr.77.7.766
Volume/Issue:
Volume 77: Issue 7
Online Publication Date:
01 Jul 2016
Restricted access
Sign In Reprints and Permissions Purchase Article

Abstract

OBJECTIVE To evaluate the potential usefulness of epiduroscopy for clinical diagnosis and treatment of vertebral canal and spinal cord lesions in dogs.

SAMPLE Cadavers of 6 mixed-breed dogs.

PROCEDURES Dogs were positioned in sternal recumbency, and an endoscope was introduced into the lumbosacral epidural space. A fiberscope (diameter, 0.9 mm; length, 30 cm) was used for 3 dogs, and a videoscope (diameter, 2.8 mm; length, 70 cm) was used for the other 3 dogs. Visibility and identities of anatomic structures were recorded, and maneuverability of the endoscopes was assessed. Extent of macroscopic tissue damage was evaluated by manual dissection of the vertebral canal at the end of the procedure.

RESULTS Intermittent saline (0.9% NaCl) solution infusion, CO2 insufflation, and endoscope navigation improved visualization by separating the epidural fat from the anatomic structures of interest. Images obtained with the fiberscope were small and of poor quality, making identification of specific structures difficult. Maneuverability of the fiberscope was difficult, and target structures could not be reliably reached or identified. Maneuverability and image quality of the videoscope were superior, and spinal nerve roots, spinal dura mater, epidural fat, and blood vessels could be identified. Subsequent manual dissection of the vertebral canal revealed no gross damage in the spinal cord, nerve roots, or blood vessels.

CONCLUSIONS AND CLINICAL RELEVANCE A 2.8-mm videoscope was successfully used to perform epiduroscopy through the lumbosacral space in canine cadavers. Additional refinement and evaluation of the technique in live dogs is necessary before its use can be recommended for clinical situations.

Abstract

OBJECTIVE To evaluate the potential usefulness of epiduroscopy for clinical diagnosis and treatment of vertebral canal and spinal cord lesions in dogs.

SAMPLE Cadavers of 6 mixed-breed dogs.

PROCEDURES Dogs were positioned in sternal recumbency, and an endoscope was introduced into the lumbosacral epidural space. A fiberscope (diameter, 0.9 mm; length, 30 cm) was used for 3 dogs, and a videoscope (diameter, 2.8 mm; length, 70 cm) was used for the other 3 dogs. Visibility and identities of anatomic structures were recorded, and maneuverability of the endoscopes was assessed. Extent of macroscopic tissue damage was evaluated by manual dissection of the vertebral canal at the end of the procedure.

RESULTS Intermittent saline (0.9% NaCl) solution infusion, CO2 insufflation, and endoscope navigation improved visualization by separating the epidural fat from the anatomic structures of interest. Images obtained with the fiberscope were small and of poor quality, making identification of specific structures difficult. Maneuverability of the fiberscope was difficult, and target structures could not be reliably reached or identified. Maneuverability and image quality of the videoscope were superior, and spinal nerve roots, spinal dura mater, epidural fat, and blood vessels could be identified. Subsequent manual dissection of the vertebral canal revealed no gross damage in the spinal cord, nerve roots, or blood vessels.

CONCLUSIONS AND CLINICAL RELEVANCE A 2.8-mm videoscope was successfully used to perform epiduroscopy through the lumbosacral space in canine cadavers. Additional refinement and evaluation of the technique in live dogs is necessary before its use can be recommended for clinical situations.

Contributor Notes

Address correspondence to Dr. Garcia-Pereira (garciaf@ufl.edu).
Cover American Journal of Veterinary Research
American Journal of Veterinary Research
Publication Date:
01 Jul 2016

  • 1. Sakai T, Aoki H, Hojo M, et al. Adhesiolysis and targeted steroid/local anesthetic injection during epiduroscopy alleviates pain and reduces sensory nerve dysfunction in patients with chronic sciatica. J Anesth 2008; 22: 242–247.

    • Search Google Scholar
    • Export Citation

  • 2. Shutse G, Kurtse G, Grol O, et al. Endoscopic method for the diagnosis and treatment of spinal pain syndromes [in Russian]. Anesteziol Reanimatol 1996; 4: 62–64.

    • Search Google Scholar
    • Export Citation

  • 3. Kallewaard JW, Vanelderen P, Richardson J, et al. Epiduroscopy for patients with lumbosacral radicular pain. Pain Pract 2014; 14: 365–377.

  • 4. Vanelderen P, Van Boxem K, Van Zundert J. Epiduroscopy: the missing link connecting diagnosis and treatment? Pain Pract 2012; 12: 499–501.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 5. Bosscher HA, Heavner JE. Incidence and severity of epidural fibrosis after back surgery: an endoscopic study. Pain Pract 2010; 10: 18–24.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 6. Bosscher HA, Heavner JE. Lumbosacral epiduroscopy findings predict treatment outcome. Pain Pract 2014; 14: 506–514.

  • 7. Prange T, Carr EA, Stick JA, et al. Cervical vertebral canal endoscopy in a horse with cervical vertebral stenotic myelopathy. Equine Vet J 2012; 44: 116–119.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 8. Prange T, Derksen FJ, Stick JA, et al. Cervical vertebral canal endoscopy in the horse: intra- and postoperative observations. Equine Vet J 2011; 43: 404–411.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 9. Prange T, Derksen FJ, Stick JA, et al. Endoscopic anatomy of the cervical vertebral canal in the horse: a cadaver study. Equine Vet J 2011; 43: 317–323.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 10. Lee GW, Jang SJ, Kim JD. The efficacy of epiduroscopic neural decompression with Ho:YAG laser ablation in lumbar spinal stenosis. Eur J Orthop Surg Traumatol 2014; 24 (suppl 1): S231–S237.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 11. Lee F, Jamison DE, Hurley RW, et al. Epidural lysis of adhesions. Korean J Pain 2014; 27: 3–15.

  • 12. Jo DH, Kim ED, Oh HJ. The comparison of the result of epiduroscopic laser neural decompression between FBSS or not. Korean J Pain 2014; 27: 63–67.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 13. Di Donato A, Fontana C, Pinto R, et al. The effectiveness of endoscopic epidurolysis in treatment of degenerative chronic low back pain: a prospective analysis and follow-up at 48 months. Acta Neurochirurgica 2011;108:S67–S73.

    • Search Google Scholar
    • Export Citation

  • 14. Garcia-Pereira FL, Hauptman J, Shih AC, et al. Evaluation of electric neurostimulation to confirm correct placement of lumbosacral epidural injections in dogs. Am J Vet Res 2010; 71: 157–160.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 15. Garcia-Pereira FL, Sanders R, Shih AC, et al. Evaluation of electrical nerve stimulation for epidural catheter positioning in the dog. Vet Anaesth Analg 2013; 40: 546–550.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 16. Fletcher TF, Kitchell RL. Anatomical studies on the spinal cord segments of the dog. Am J Vet Res 1966; 27: 1759–1767.

Advertisement