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230 Section III: Spinal Procedures

A B

Figure 26.12 Intraoperative image of a dog treated by dorsal laminectomy and stabilized using pedicle screws. Two pedicle screws were implanted and con-
nected with a rod held by fixation clamps (A). A pedicle screw can be seen prior to insertion within the insertion device (B).

B

Table 26.1 Summary of the recent studies evaluating surgical outcomes in dogs with DLSS.
Study Danielsson & Janssens et al. Jones et al. De Risio et al. Linn et al. Kinzel et al. Van Klaveren Godde & Suwankong Suwankong
̈

Sjöström (2000) [77] (2000) [42] (2001) [75] (2003) [72] (2004) [55] et al. (2005) [73] Steffen et al. (2007) et al. (2008)

(1999) [53] (2007) [56] [76] [74]

Design Retrospective Retrospective Prospective Retrospective Retrospective Retrospective Prospective Retrospective Prospective Retrospective
Outcome Medical records and Questionnaire Standardized obstacle Reevaluation at VTH, Medical records Medical records Force plate analysis Medical records, Force plate and Medical
assessment telephone interview course 6 months after by rDVM and owner follow up owner records (MR)
surgery questionnaire examinations questionnaire and owner
and owner questionnaire
telephone (OQ)
interviews
A Technique Dorsal laminectomy/ Dorsal Dorsal laminectomy ± Dorsal laminectomy/ Dorsal Partial dorsal Dorsal laminectomy ± Lateral Dorsal Dorsal
discectomy ± laminectomy, foraminotomy and discectomy/ laminectomy ± laminectomy fenestration and foraminotomy ± laminectomy laminectomy ±
foraminotomy annulectomy facetectomy foraminotomy facetectomy, discectomy partial dorsal and discectomy discectomy,
and discectomy foraminotomy, laminectomy ± facetectomy,
discectomy, annulectomy foraminotomy
traction fusion
Number of 131 35 12 military working 69 29 military working 86 12 20 31 156
dogs dogs dogs
Normal 78.6% 53% 8 fit for full duty 38% 41% 3 propulsive 40% 50% NA
force = control dogs
Improved 18% 32% 3 not fit for full duty but 40% 38%, but 54.5% of 96.5% 7 propulsive force 55% 36% 79% MR
could do reduced duty this group recurred improved 76% OQ
Not improved 3.1% 15% 1 22% 21% 1.2% 2 propulsive force 1 9% 21% MR
decreased 24% OQ
Recurrence 18% 16% NA 3% 17% 2.4% NA NA 27% NA
Figure 26.13 Lateral (A) and ventrodorsal (B) radiographic projections of a dog treated by dorsal laminectomy, annulectomy, and discectomy followed by
stabilization with an intervertebral spacer screw and pedicle screws. Note the enlargement of the intervertebral foramina and spreading of the intervertebral
disc space compared with the preoperative radiographs seen in Figure 26.2. Source: Courtesy of Dr. N. Fitzpatrick.
75–90% of dogs reportedly achieve good to excellent function function, and this number may be lower for working dogs.
postoperatively [42,53,55,56,72–80]. Recurrence rates are quite Recurrence of clinical signs may be related to residual compres-
variable between studies (2.4–27%). This range may be due to sion, instability, or laminectomy membrane formation, which
the length and type of follow‐up achieved but may also vary can occur months to years after surgery [53,73–75].
depending whether the animals are pets or working dogs. It
would be expected that military working dogs may have a higher
recurrence rate if returned to active duty [72]. Dogs with more
severe preoperative neurological deficits, and especially dogs
with signs of urinary incontinence, seem to carry a worse prog- Video clips to accompany this book can be found on
nosis [53,75,79,80]. One study reported a decreased prognosis the companion website at:
for older dogs, particularly working dogs [73]. Overall, most www.wiley.com/go/shores/neurosurgery
dogs improve postoperatively but only 50% return to full