Recurrence of cervical intervertebral disc extrusion in 55 dogs after surgical decompression with or without prophylactic fenestration.

Abstract

OBJECTIVE: To determine whether prophylactic fenestration (PF) of adjacent intervertebral discs decreases the recurrence rate (RR) of cervical intervertebral disc extrusion (C-IVDE) in small dogs undergoing ventral slot (VS) decompression, and whether PF increases perioperative complication risk. STUDY DESIGN: Retrospective, multi-institutional cohort study. SAMPLE POPULATION: A total of 55 dogs. METHODS: Medical records of a mixed population of small dogs (<20&#x2009;kg) treated with VS for C-IVDE with a minimum one-year follow-up were reviewed. During surgery, dogs underwent either single-site PF, multiple-site PF, or no PF. Perioperative complication rate and RR were compared between PF and non-PF groups using generalized linear models. Surgical time and neurologic grade (presurgery, post-surgery, at first recheck) were compared with Mann-Whitney test and chi-squared tests. RESULTS: A total of 55 dogs were included (PF: n&#x2009;=&#x2009;18; non-PF: n&#x2009;=&#x2009;37). Neurologic grades were similar at all timepoints. Median time to first recheck was 14&#x2009;days (range: 5-56). Median follow-up time was 1380&#x2009;days (range: 365-2777). Recurrence occurred in 25% of dogs (14/55), all in the non-PF group. Prophylactic fenestration was associated with a lower RR (p&#x2009;<&#x2009;.001). Surgery duration was longer in the PF group (158.0&#x2009;&#xb1;&#x2009;13.5&#x2009;min) versus non-PF (118.0&#x2009;&#xb1;&#x2009;6.8&#x2009;min, p&#x2009;=&#x2009;.017), but complication rates were similar (18.2%, p&#x2009;=&#x2009;.838) between groups. CONCLUSION: Recurrence of C-IVDE is more likely to occur at non-PF group than PF-group in a heterogenous population of small breed dogs. Prophylactic fenestration was not linked to increased complication risk. CLINICAL SIGNIFICANCE: Prophylactic fenestration might be safely considered to prevent C-IVDE recurrence.