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Recurrence of thoracolumbar intervertebral disk extrusion in chondrodystrophic dogs after surgical decompression with or without prophylactic fenestration: 265 cases (1995–1999)

Brigitte A. Brisson DMV, DVSc, DACVS1, Shannon L. Moffatt BSc2, Seanna L. Swayne3, and Joane M. Parent DMV, MVetSc, DACVIM4
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  • 1 Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1.
  • | 2 Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1.
  • | 3 Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1.
  • | 4 Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1.

Abstract

Objectives—To evaluate a population of chondrodystrophic dogs treated for Hansen type I intervertebral disk (IVD) disease by surgical decompression with or without prophylactic fenestration and determine the rate and location of surgically confirmed recurrence of intervertebral disk extrusion.

Animals—265 dogs.

Study Design—Retrospective study.

Procedures—Medical records of dogs that underwent spinal decompression between 1995 and 1999 were reviewed.

Results—13 (4.9%) dogs were euthanatized or died prior to discharge. Fenestration was performed in 252 dogs, including 37 (14.7%) at the site of decompression only, 48 (19%) at 3 to 4 disk spaces, and 167 (66%) at 5 to 7 disk spaces. There were 12 instances of recurrent disk extrusion confirmed by removal of disk at a second surgery 3.5 to 33 months after the first surgery. Recurrence was always at a new disk space, and rates did not significantly differ between dogs that underwent single or multiple fenestrations. Two recurrences were at a previously fenestrated disk space. Seven recurrences were at a site immediately adjacent to a fenestrated disk space, and 5 recurrences were at L4-5.

Conclusions and Clinical Relevance—Prophylactic fenestration is generally successful in preventing future disk extrusions at fenestrated disk spaces. Prospective evaluation is still required to determine whether fenestration decreases the overall rate of recurrence. Prophylactic fenestration could promote disk extrusion at adjacent, nonfenestrated disk spaces. This could have a substantial clinical impact if recurrence develops at L4-5. (J Am Vet Med Assoc 2004;224:1808–1814)

Abstract

Objectives—To evaluate a population of chondrodystrophic dogs treated for Hansen type I intervertebral disk (IVD) disease by surgical decompression with or without prophylactic fenestration and determine the rate and location of surgically confirmed recurrence of intervertebral disk extrusion.

Animals—265 dogs.

Study Design—Retrospective study.

Procedures—Medical records of dogs that underwent spinal decompression between 1995 and 1999 were reviewed.

Results—13 (4.9%) dogs were euthanatized or died prior to discharge. Fenestration was performed in 252 dogs, including 37 (14.7%) at the site of decompression only, 48 (19%) at 3 to 4 disk spaces, and 167 (66%) at 5 to 7 disk spaces. There were 12 instances of recurrent disk extrusion confirmed by removal of disk at a second surgery 3.5 to 33 months after the first surgery. Recurrence was always at a new disk space, and rates did not significantly differ between dogs that underwent single or multiple fenestrations. Two recurrences were at a previously fenestrated disk space. Seven recurrences were at a site immediately adjacent to a fenestrated disk space, and 5 recurrences were at L4-5.

Conclusions and Clinical Relevance—Prophylactic fenestration is generally successful in preventing future disk extrusions at fenestrated disk spaces. Prospective evaluation is still required to determine whether fenestration decreases the overall rate of recurrence. Prophylactic fenestration could promote disk extrusion at adjacent, nonfenestrated disk spaces. This could have a substantial clinical impact if recurrence develops at L4-5. (J Am Vet Med Assoc 2004;224:1808–1814)