Cervical ventral slot surgery
Imaging that indicate a spinal cord compression are best dealt with surgically. If the lesion or disc is in the region of the cervical spinal cord a procedure called a ventral slot can be performed. Ventral Slot. This is the procedure employed when a disc is compressing a nerve root or an area of the cervical spinal cord. The chances of damaging the spinal cord as a result of surgery, although rare, are higher with the cervical ventral slot procedure. Although this surgery is less invasive than similar procedures – including dorsal laminectomy and hemilaminectomy – the surgeon will . Jul 23, · In dogs, there are two potential types of neck surgery options: Dorsal Cervical Hemilaminectomy and Ventral Slot Procedure. Veterinarian Dr. Fernandez goes over these dog neck surgery procedures and costs in the article below.
Treatment and Prognosis – Wobbler Syndrome
A slot is performed between the two vertebrae until the protruded disc with the associated thickened ligaments are reached and removed. This prosthesis is rotationally unconstrained, following the ball-end-socket principle, and independent of supplemental fixation. Ventral decompression using the modified slanted slot instead of the standard ventral slot will allow for spinal decompression with potentially less destabilisation, and incur a similar incidence of complications and rate of recovery. A requiring intense post-operative nursing care. The heat generated during polymerization of the PPMA may cause end plate necrosis, with intrusion of the PMMA plug into the vertebra and consequently distraction failure. Cervical spondylomyelopathy. Vet Surg a;
The surgical approach to the affected disc is most difficult in the cervical region. Which method is the best? The objective of this study was to compare the recovery times and complication rates between the standard ventral slot and the modified slanted ventral slot for the treatment of cervical disc disease in dogs with the same neurological grade.
A retrospective analysis of an equal number of cervical disc cases for each procedure was carried out specifically to determine the recovery times and complication rates. To allow for meaningful comparison only dogs that had the same neurological grade were selected. Outcomes were determined by time to recover and the resolution of symptoms and complications were graded in terms of severity.
Results: The standard ventral slot cases had a higher complication rate than the modified slanted slot cases with one case dying in the postoperative period. However, the modified slanted slot cases on average had a marginally slower recovery time than standard ventral slot cases.
Ventral decompression using the modified slanted slot instead of the standard ventral slot will allow for spinal decompression with potentially less destabilisation, and incur a similar incidence of complications and rate of recovery. Source: W. McCartney : Comparison of recovery times and complication rates between a modified slanted slot and the standard ventral slot for the treatment of cervical disc disease in 20 dogs.
However, both conditions are considered surgical diseases and medical conservative treatment is associated with a guarded prognosis. While for BAWS direct spinal cord decompression through a dorsal laminectomy or hemilaminectomy seems to be the best way to treat this disease process, the ideal surgical procedure for DAWS still does not exist. Preliminary clinical studies are showing that cervical disc prosthesis may be a valuable method to treat DAWS in dog.
Activity restriction and corticosteroids may be indicated in a normal dog with a first episode of neurologic deficits following minor trauma; otherwise, surgery is the treatment of choice. Conservatively treated dogs should have activity restriction for at least two months — they can be walked on leash preferably attached to a chest harness rather than a collar , but free unsupervised activity should be avoided. This is to minimize high impact activities that could exacerbate the dynamic component of spinal cord compression.
Corticosteroids at an anti-inflammatory dose prednisone 0. However, due to the many side effects of corticosteroid, their prolonged use is not recommended. Nonsteroidal anti-inflammatory drugs NSAIDs may be used when corticosteroids are contraindicated or when clinical signs are limited to cervical pain. The use of corticosteroids is more indicated in patients with more severe neurologic signs ataxia, paraparesis or tetraparesis , and their ability to reduce interstitial spinal cord edema may have some prognostic value in establishing the reversibility of the spinal cord lesion.
Physical therapy and electroacuncture have also been reported. In all dogs in which conservative medical treatment was unsuccessful, the neurologic condition had deteriorated at 1 month after diagnosis of DAWS. In these dogs, deterioration of clinical status was generally rapid and progressed to tetraplegia within 6 months after diagnosis.
This may be used as a prognostic indicator and for earlier identification of surgical candidates, before the spinal cord damage becomes irreversible. The surgical techniques can be broadly divided into three categories: a direct access decompression, b indirect decompression by ventral distraction-stabilization-fusion c direct decompression with distraction and dynamic stabilization. Reported results for surgical treatment of DAWS are summarized in table 1.
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