CANINE LUMBOSACRAL SPINAL FUSION TECHNIQUES

摘要

The severity of clinical signs for dogs presenting with lumbosacral instability can vary. The patient's disease must be distinguished from other factors causing pain or neurologic impairment that localizes to the lumbosacral spine or pelvis. The diagnosis and treatment of lumbosacral instability can be challenging. Many dogs are successfully treated by surgical decompression alone. However, as lumbosacral disease varies between dogs, decompression alone may not be adequate in some patients. Specific guidelines for the definitive diagnosis of instability do not exist. Often following imaging, the neurosurgeon is left asking, "To fuse or not to fuse? It is the author's contention that in some patients, continued movement of the lumbosacral spine despite decompression will result in a failure of resolution of clinical signs. Of particular concern is that narrowing of the intervertebral foramen at L7-S1 will continue to cause nerve compression and subsequent pain. Fusion of the lumbosacral spine eliminates this dynamic source of nerve compression. Another mechanism for spinal nerve decompression is a foramintomy.2 This procedure may provide adequate nerve decompression, but may be technically challenging and may contribute to instability.