Operative Techniques and Preliminary Outcomes Following Percutaneous Endoscopic Thoracolumbar Pediculectomy in Dogs.

ABSTRACT

OBJECTIVE: To examine the technical feasibility of percutaneous endoscopic pediculectomy using a lateral approach and to evaluate its use for decompression and examination of the thoracic and lumbar spinal canals in small dogs. STUDY DESIGN: Experimental study. ANIMALS Clinically normal adult dogs (n=10). METHODS: After optimizing the technique in cadavers, percutaneous endoscopic pediculectomy was performed using a lateral approach to the thoracic (T12) or lumbar (L2) vertebrae in 5 dogs each. Using fluoroscopic guidance, a K-wire, dilator, and (cannula) working sleeve were placed. A window for visualizing the spinal cord and floor of the spinal canal was created using a specialized drill, rongeurs, trephine, and elevator. Gait and neurologic status were monitored postoperatively, and computed tomography (CT) and magnetic resonance imaging (MRI) performed. RESULTS: All procedures were completed successfully (T12, 45 ± 13 minutes; L2, 59 ± 14 minutes) with clear observation of the spinal cord and floor of the spinal canal. Normal ambulation was maintained in 9 dogs. One dog in the L2 group had ipsilateral hind limb weakness that resolved within 4 days. One dog in the L2 group suffered a fracture of the accessory process. One dog each in the T12 and L2 groups had hyperintense lesions on T2-weighted MRI images, suspicious of focal edema, which reduced at 4 weeks after initial examination, possibly reflecting gliosis. CONCLUSION: Pediculectomy using a percutaneous endoscopic thoracolumbar lateral approach is feasible, provides a good view of the spinal canal, and may be an alternative for treatment of disk disease in dogs.