Long-term neurologic outcome of hemilaminectomy and disk fenestration for treatment of dogs with thoracolumbar intervertebral disk herniation: 831 cases (2000-2007)

Objective—To determine the proportion of dogs with thoracolumbar intervertebral disk herniation (IVDH) that successfully recovered following hemilaminectomy and fenestration, the time to ambulation (TTA) in affected dogs after surgery, and the frequency of urinary and fecal incontinence in recovered dogs and to document long-term complications. Design—Retrospective case series. Animals—831 dogs with thoracolumbar IVDH treated by hemilaminectomy and concomitant disk fenestration by the same surgeon. Procedures—For all dogs, neurologic deficits before surgery had been assessed with a modified grading system. Dogs were reexamined after surgery over a period of 3 to 6 months, and follow-up evaluation was performed at > 12 months. The proportion of dogs that neurologically improved after surgery, TTA, and incidence of fecal or urinary incontinence in recovered dogs were compared among dogs with various grades of neurologic dysfunction before surgery. Results—Of 831 dogs, 122 had unsuccessful outcomes and 709 had successful outcomes. Of 620 dogs with intact deep nociception before surgery, 606 (97.7%) were ambulatory after surgery. Despite maintaining the ability to walk, 7 dogs were judged to have an unsuccessful outcome because the severity of ataxia did not improve. Of 211 paraplegic dogs with loss of deep nociception, 110 (52.1%) dogs became ambulatory after surgery. Long-term complications included incontinence, permanent neurologic deterioration, and self-mutilation. Dogs with paraplegia before surgery had a higher frequency of urinary or fecal incontinence, compared with dogs that were ambulatory. Conclusions and Clinical Relevance—Prognosis for dogs with thoracolumbar IVDH that retain deep nociception in at least 1 of the pelvic limbs or tail before surgery was good.