title: Minimally invasive approach to lumbosacral decompression in a cadaveric canine model.
abstract: OBJECTIVE
  To determine efficacy of a minimally invasive (MI) surgical approach using a human MI lumbar retractor for canine lumbosacral dorsal laminectomy and partial discectomy and to compare this technique to the standard open surgical (OS) approach.
  
  
  METHODS
  Lumbosacral dorsal laminectomy and partial discectomy was performed on 16 large-breed canine cadavers using either a standard OS (n=8) or MI (n=8) approach. Skin and fascial incision length, procedure time, and intraoperative complications were recorded. Postoperatively specimens were evaluated for laminectomy and discectomy dimensions, and visible damage to the cauda equina and exiting nerve roots.
  
  
  RESULTS
  Median length of skin and fascial incisions in the OS group were longer than in the MI group (p<0.001). Median laminectomy length was similar between both approaches (p=0.234) but width was greater for the MI than OS approach (p=0.002). Both approaches achieved similar partial discectomy width (p=0.279). Overall surgical time was longer for MI approaches compared to OS, with a median of 18.5 (min 15.5, max 21.8) minutes for MI compared to 14.6 (min 13.1, max 16.9) minutes for OS (p=0.001).
  
  
  CONCLUSIONS
  The MI approach reduced incision lengths while retaining comparable laminectomy and discectomy dimensions. For this in vitro model the MI approach required more time to complete, but this difference may not be relevant in clinical cases.
  
  
  CONCLUSIONS
  Dogs undergoing lumbosacral dorsal laminectomy are commonly large-breed dogs. The traditional open approach requires a large skin incision and soft tissue dissection, especially in overweight animals. A MI approach accomplishing the same surgical result while minimising soft tissue trauma could reduce post-operative pain and recovery time, and may lower wound-related complications. Clinical studies are needed to confirm postoperative benefit and assess operating times in vivo.
authors.affiliation: a Department of Veterinary Clinical Sciences , College of Veterinary Medicine, The Ohio State University , 201 Vernon Tharp Street, Columbus OH 43210 , USA.
authors.forename: B T
authors.initials: BT
authors.lastname: Dent
authors.affiliation: b Department of Production Animal Studies, Faculty of Veterinary Science , University of Pretoria , South Africa.
authors.forename: G T
authors.initials: GT
authors.lastname: Fosgate
authors.affiliation: a Department of Veterinary Clinical Sciences , College of Veterinary Medicine, The Ohio State University , 201 Vernon Tharp Street, Columbus OH 43210 , USA.
authors.forename: B F
authors.initials: BF
authors.lastname: Hettlich
mesh_terms: D000818:Animals; D002102:Cadaver; D019299:Decompression, Surgical / Q000379:methods / Q000662:veterinary*; D004285:Dogs / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000662:veterinary*; D012447:Sacrum / Q000601:surgery*
keywords: Dog; dorsal laminectomy; lumbar retractor; lumbosacral; minimally invasive surgery