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Thoracolumbar dorsolateral laminectomy with osteotomy of the spinous process in fourteen dogs.

OBJECTIVE
To describe outcome after an alternative unilateral approach to the thoracolumbar spine for dorsal laminectomy.


STUDY DESIGN
Retrospective clinical study.


ANIMALS
Dogs (n=14) with thoracolumbar spinal cord compression.


METHODS
Thoracolumbar spinal cord compression was lateral (6 dogs), dorsal (4), and dorsolateral (4) caused by subarachnoid (7) and synovial cysts (2) and intradural-extramedullary neoplasia (5). All dogs were treated by dorsal laminectomy with osteotomy of the spinous process using a unilateral paramedian approach. The contralateral paraspinal muscles were not stripped from the spinous process and the osteoligamentous complexes were preserved. Retraction of the spinous process and muscles to the contralateral side resulted in complete visualization of the dorsal vertebral arch thereby allowing dorsal laminectomy to be performed.


RESULTS
No technique complications occurred. Approximately 75% exposure of the spinal cord (dorsal and lateral compartments) was achieved providing adequate visualization and treatment of the lesions. Transient deterioration of neurologic state occurred in 5 dogs because of extensive spinal cord manipulation. At long-term follow-up, 6 dogs were normal, 6 had clinical improvement, and 2 were unchanged.


CONCLUSION
Dorsal laminectomy after osteotomy and retraction of the spinous process may be considered in canine patients with dorsal, dorsolateral, or lateral compression to facilitate adequate decompression of the spinal cord.


CLINICAL SIGNIFICANCE
This surgical technique offers an alternative approach to the thoracolumbar spine and spinal cord by a modified dorsal laminectomy that preserves the paraspinal muscle integrity on the contralateral side.