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Chapter 17: Ventral Cervical Decompression 161

ative complications were done several years ago when blood pres- without NSAIDs such as meloxicam or carprofen. If muscle spasms
sure monitoring was not routinely used. Aggressive monitoring of are present, muscle relaxants such as methocarbamol or diazepam
blood pressure to identify hypotension as soon as it occurs is can be used. Gabapentin is also an option for patients with more
important to minimize complications. Intraoperative hypotension severe pain. Mild cervical discomfort can be managed with trama-
may lead to postoperative neurological deterioration secondary to dol. Ice packing can be performed every 4–6 hours for 24–48 hours
spinal cord hypotension during surgery. in an attempt to reduce postsurgical swelling and seroma forma-
tion. Nonambulatory dogs should receive physical therapy, and
Neurological Complications great care should be paid to bedding and cleanliness [2].
Excessive manipulation of the spinal cord, prolonged anesthesia for
a patient with a chronically compromised spinal cord, intraoperative Video clips to accompany this book can be found on
spinal cord hypotension, and excessive cervical extension during the companion website at:
surgery can all result in neurological deterioration after the surgical www.wiley.com/go/shores/neurosurgery
procedure. Marked neurological deterioration is uncommon but is
occasionally seen. Incomplete spinal decompression was a frequent
cause of neurological worsening or failure to improve after surgery
leading to euthanasia in a case series of Dobermans with cervical References
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pression was found at necropsy in six of seven dogs, even though system. In: Slatter DH (ed.) Textbook of Small Animal Surgery, 3rd edn. Philadelphia,
PA: WB Saunders, 2003:1148–1163.
the surgery report of these cases indicated complete spinal cord 2 Sharp NJH, Wheeler SJ. Cervical disc disease. In: Sharp NJH, Wheeler SJ (eds)
decompression [15]. Worsening of neck pain may also be seen and Small Animal Spinal Disorders: Diagnosis and Surgery, 2nd edn. Philadelphia, PA:
can be managed postoperatively with opioids, muscle relaxants, Elsevier Mosby, 2005:93–120.
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Vertebral Instability and Subluxation 8 Goring RL, Beale BS, Faulkner RF. The inverted cone decompression technique: a
Ventral slots alter the vertebral range of motion at the surgical site surgical treatment for cervical vertebral instability “Wobbler syndrome” in
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was noted in most dogs after cervical vertebral stabilization surgery. anesthesia for cervical decompression in the dog. Am J Vet Res 1988;49:1143–1146.
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18 Fauber AE, Wade JA, Lipka AE, McCabe JB, Aper RL. Effect of width of disk fenes-
Postoperative Care tration and a ventral slot on biomechanics of the canine C5–C6 vertebral motion
Postoperative care of the ventral slot patient involves cage rest for unit. Am J Vet Res 2006;67:1844–1848.
most of the day with monitored leash walks using a body harness. 19 Koehler CL, Stover SM, LeCouteur RA, Schulz KS, Hawkins DA. Effect of a ventral
slot procedure and of smooth or positive‐profile threaded pins with polymethyl-
Activity should be very limited in the first 2 weeks after surgery. methacrylate fixation on intervertebral biomechanics at treated and adjacent
Frequency and duration of walks increases progressively but free canine cervical vertebral motion units. Am J Vet Res 2005;66:678–687.
activity should only be allowed once fusion of the slot is complete or 20 Lemarie RJ, Kerwin SC, Partington BP, Hosgood G. Vertebral subluxation following
close to complete 8 weeks postoperatively. Pain control is important ventral cervical decompression in the dog. J Am Anim Hosp Assoc 2000;36:348–358.
in the postoperative period and can be achieved with opioids such 21 Fitch RB, Kerwin SC, Hosgood G. Caudal cervical intervertebral disk disease in the
small dog: role of distraction and stabilization in ventral slot decompression. J Am
as fentanyl as a constant‐rate infusion and fentanyl patches with or Anim Hosp Assoc 2000;36:68–74.