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206  Section III: Spinal Procedures


           A                                                    A                      B











                                                                C                      D




           B



                                                             Figure 24.2  Illustration of (A) Funkquist A, (B) Funkquist B, (C) modified,
                                                             and (D) deep dorsal laminectomies. See text for details. Source: illustration
                                                             by Andy Shores.

                                                              A




           Figure 24.1  To limit the possibility of a laminectomy membrane, (A) syn-
           thetic nonabsorbable #1 or #2 suture material in a figure‐of‐eight pattern or
           (B) a preserved supraspinous ligament (arrow) is used to span the length of
           the dorsal laminectomy by attachment to the nearest cranial and caudal
           spinous processes. The muscle is sutured over the figure‐of‐eight suture or
           ligament. In (A) the spinal cord is protected with sheets of a gelatin sponge,
           and in (B) with an autogenous free fat graft.

           supraspinous ligament can be preserved and reattached at the end
           of the procedure to span the defect (Figure 24.1). The suture is
           placed either around the spinous processes or through a small   B
           hole that is made in the spinous processes cranial and caudal to
           the laminectomy site [3,12]. The fascia and epaxial muscles are
           closed with absorbable suture in a simple continuous pattern over
           the spanning suture [3,12]. Closure of the subcutaneous tissue and
           skin is in routine fashion.


           Classification of Dorsal Laminectomies

           Funkquist A Method
           Funkquist A dorsal laminectomy involves removal of the spinous
           process, cranial and caudal articular processes, dorsal laminae, and
           pedicle to the appropriate height, usually to the level of the spinal
           cord (Figure 24.2A) [13–15].

           Funkquist B Method
           Funkquist B dorsal laminectomy involves removal of the spinous
           process and dorsal lamina. Both cranial and caudal articular pro-
           cesses are preserved. This technique allows limited access to the
           vertebral canal (Figure 24.2B) [13–15].

           Modified Dorsal Laminectomy
           The modified dorsal laminectomy, the most commonly used   Figure  24.3  (A) Lateral and (B) ventrodorsal radiographs after T11–T12
             technique, involves the removal of an amount of lamina intermedi-  dorsal laminectomy with stabilization in a Chinese Pug with constrictive
           ate between Funkquist A and Funkquist B, with preservation of the   myelopathy.
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