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Laminectomy

By: Dr. Nicholas Trout

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Laminectomy refers to a surgical procedure in which a portion of the bone of a spinal vertebra is removed to allow access to the spinal canal and/or achieve decompression of the spinal cord. The most common indication for performing a laminectomy is the treatment of intervertebral disc disease. Disc can be extruded into the spinal canal causing spinal cord bruising and swelling. Only by removing a window of bone can a surgeon get access to the disc and remove the pressure on the spinal cord.

The most common types of laminectomy are a dorsal laminectomy, where bone is removed from the top of a spinal vertebra and hemilaminectomy, where the bone is removed from the side of the vertebra.

Laminectomy is more commonly performed on small breeds of dogs with long spines such as dachshunds, Pekingnese and Lhasa apsos, since these are the breeds of dog most affected by disc problems.

Veterinary Care

Prior to laminectomy your pet will undergo a thorough physical examination and neurological examination. If disc disease is suspected (or some other spinal cord disorder that would benefit from exploratory surgery of the cord e.g. a tumor), your veterinarian will need to find the exact location of the lesion. In some cases a plain X-ray of the spine will be suspicious for a disc problem, but usually this is accompanied by a spinal dye study (myelogram), or a CT scan or MRI.

Most laminectomies are performed by approaching the vertebra from directly on top of the spine or slightly to one side, dependent on the site of the problem. Bone is usually removed using a drill or nibbled off using an instrument called a rongeur.

Once the bone has been carefully removed, the spinal cord can be visualized and extruded disc material removed. The space where the bone used to exist can be covered by a small piece of fat, usually taken from the layer below the skin. This will protect the bone defect as it heals, helping to prevent scar tissue from pinching on the exposed spinal cord.

Analgesics will be given before and immediately after surgery to ensure that your pet is comfortable. They may continue for several days following the surgery and the early phase of recuperation at home.

Most pets receive antibiotics at the time of the surgery and do not require any more during the postoperative period.

Home Care

Following laminectomy, all pets require strict confinement and rest. If your pet does not respond well to a carrier or cage, cordon off a portion of a room, such as the kitchen.

If your pet can walk, avoid jumping on or off furniture, avoid going up or down stairs. Just go out on a leash to go to the bathroom and then go straight back inside to continue with rest. A total of 4 to 6 weeks of strict rest is usually necessary following laminectomy surgery. Assistance may be required to get your dog up and walking in order to go outside. A towel slung underneath the tummy can prove helpful.

Medication may be necessary to assist your pet with normal urination, particularly to prevent accidents in the house. It is important to provide plenty of soft padded bedding to avoid the production of pressure sores. The incision following laminectomy should be checked daily for swelling redness or discharge. The stitches or staples should be removed by your veterinarian in two weeks.

Preventative Care

For owners of dogs predisposed to back problems, be aware of the earliest indication of intervertebral disc disease such as back pain, clumsiness, walking as if drunk, inability to get up and dragging of the back legs. Seek veterinary advice early to offer your pet the best possible prognosis.

Avoid excessive weight gain as obesity will further stress the mid-portion of the spine of these "long dogs."

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