Recurrent Thoracolumbar Intervertebral Disc Extrusion after Hemilaminectomy and Concomitant Prophylactic Fenestration in 662 Chondrodystrophic Dogs

Abstract

OBJECTIVES: To determine the prevalence and location of recurrent thoracolumbar intervertebral disc extrusion (T-L IVDE) after hemilaminectomy with prophylactic fenestration (PF) and to document PF-related complications. STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: Chondrodystrophic dogs (n = 793). METHODS: In 662 successfully recovered dogs (>1 year follow-up), the prevalence of dogs with recurrent T-L IVDE that required a 2nd surgery and dogs with clinical signs that improved without surgery was evaluated. Prevalence of second disc extrusions (SDEs) within T11-L4 intervertebral discs was compared between PF discs and non-PF discs. RESULTS: T-L SDEs were intraoperatively confirmed in 15 dogs (2.3%), 2-61 months after initial surgery and 66 dogs (10.0%) had signs of T-L IVDE recurrence that improved without surgery (mean follow-up, 44.7 months). No dog had further extrusion at the initial T-L site. SDE occurred at a PF disc (n = 1), adjacent to PF discs (8), or at distant discs (6). Prevalence of SDE in non-PF discs was 26.2 times higher than PF discs (95% CI: 3.4, 203.4; P < .001). Major PF-related complications included iatrogenic introduction of the disc material into the spinal canal (n = 1), and vertebral subluxation/instability (3) at 1-88 months postoperatively. CONCLUSION: SDE is more likely to occur at non-PF discs than PF discs when PF is performed at spaces predisposed to disc extrusion. PF is a safe and effective treatment to prevent SDE in chondrodystrophic dogs.