What does the surgery involve?
There are two categories of disc surgery. The easiest and one that does not require specialised equipment is fenestration. In this procedure the nuclei pulposus of T11/T12 to L3/L4 (in the case of a thoracolumbar disc extrusion) or all the cervical intervertebral spaces (in the instance of cervical disc disease) are removed through a small window in the anulus fibrosis. This is a prophylactic procedure limiting further disc extrusions. The disc material within the vertebral canal is not removed and if the dog has severe spinal cord compression then the neurological recovery will be prolonged and/or there will be residual neurological deficits. At Fitzpatrick Referrals fenestrations are usually done in combination with a decompressive technique (below).
The second type of surgery is decompressive i.e. the extruded disc material is removed from the vertebral canal. This surgery is more technically difficult and requires specialised equipment and training. The type of decompressive surgery performed depends on the site of the problem. In the neck a ventral approach is favoured (ventral slot) and a window is drilled through the vertebral bodies. For the thoracolumbar spine, the most common procedure is a hemilaminectomy, where entry into the vertebral canal is made from the side, directly above the disc space and the vertebral foramen. For lumbosacral problems a dorsal laminectomy is used where the “roof” is taken off the vertebral canal allowing direct visualisation of the cauda equina and the lumbosacral disc.
What sort of aftercare is there? At Fitzpatrick Referrals spinal patients receive physiotherapy from trained veterinary nurses and from chartered physiotherapists. When the pet discharged from Fitzpatrick Referrals the owner is taught how to perform any ongoing physiotherapy and / or the animal will continue to have sessions with the physiotherapist.