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Hemilaminectomy

A hemilaminectomy is the most common surgical approach in the thoracolumbar spine. The approach is less commonly used in the cervical spine. The surgical approach for a hemilaminectomy is from the top side of the dog or cat. Once the spinal column is reached, portions (lamina and pedicle ) of the vertebrae are removed from the side. This allows for removal of disc that has herniated off to one side or the other or removal of a tumor or cyst that may be located on one side of the spinal cord. This approach also allows direct access to the disc that lies underneath the spinal cord. It allows for greater access to the spinal canal compared to a ventral slot and allows probing (NOTE: definitely can't see beneath the cord, that's what makes surgeries hard) beneath the spinal cord which is difficult to obtain during a dorsal laminectomy. Once the portion of the vertebrae is removed during a hemilaminectomy the herniated or ruptured disc material is then removed with small instruments. The combination of the hemilaminectomy approach and disc material removal alleviates compression or pinching the spinal cord allowing further spinal cord healing to take place. During the hemilaminectomy procedure the disc

is not replaced. Fenestration of the affected disc and sometimes the nearby discs may be done depending on the clinical scenario and surgeon preference to try to prevent future herniation at those sites. Potential complications from hemilaminectomy include trauma to the spinal cord, hemorrhage, infection and instability. The prognosis with the hemilaminectomy procedure is often good, but depends on the pre-surgical condition of the pet. Dogs and cats with acute disc herniation that have the ability to feel their toes at the time of surgery typically do quite well. The success rate with surgery is less for dogs without sensation of their toes, chronic spinal cord compression and multiple compressive sites. Recovery time is variable with return to ambulation typically within weeks to months. Strict rest/confinement is recommended for about 1 month post-surgery with gradual increase in activity thereafter. During confinement a well-padded surface is recommended to prevent bed sores. It is important to ensure that your pet is urinating regularly post operatively. Urinary tract infections are common in dogs with spinal cord injury and should be monitored for. Rehabilitation therapy can assist recovery (recent study showed rehab doesn't actually affect outcome).

Ventral Slot Surgery

The surgical approach for removal of a herniated disc depends upon the location of the disc material within the spinal canal. A ventral slot procedure is the most common surgical procedure for disc herniation in the cervical spine. The approach is from the underside (ventral) of the neck, where intervertebral discs are located. A small hole (slot) is drilled through the center of the disc and a small portion of the adjacent vertebrae. This allows access to the spinal canal at the location of the herniated disc. Small instruments are then used to remove any free fragments of disc material that have herniated or ruptured into the spinal canal.

When indicated surgical success with a ventral slot procedure is good, provided that the disc herniation is acute and that neurological function is adequate at the time of surgery (removed thing about pain sensation; prognosis more variable for necks than backs and only about 80% that are done recover with abotu 20 - 25% death/euthanasia rate in down neck dogs). Potential complications include hemorrhage, post-operative infection, instability/subluxation, respiratory failure/need for mechanical ventilation and spinal cord trauma. Fusion is not typically done with routine disc herniations, as dogs do well without it and the disc space will partially fuse within a few months post operatively.

Recovery depends on the initial neurological status with return of ambulation within days to months. Strict rest/confinement is recommended for about 1 month post surgery with gradual increase in activity thereafter. During confinement a well-padded surface is recommended to prevent bed sores. Rehabilitation therapy can speed recovery.

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Surgery

What Is A Board Certified Veterinary Surgeon?

A board certified veterinary surgeon is a licensed veterinarian who has obtained intensive, additional surgical training. A veterinary surgeon can offer special assistance in the following kinds of cases:

  • Traumatic injury and emergencies (such as fractures, skin wounds and lacerations, correction of gastric dilatation-volvulus, and exploratory (abdominal/thoracic) surgery
  • Orthopedic surgeries (such as total hip replacements (THRs), cruciate ligament surgeries (TPLOs), and arthroscopy for joint exploration).
  • Soft tissue surgeries (such as tumor/cancer removal and correction of congenital defects).
  • Neurological surgeries (such as herniated discs and spinal injuries).
  • Trust VCA's Veterinary Surgeons with Your Cat or Dog's Veterinary Surgery
  • If your cat or dog needs veterinary surgery, you can't afford to get anything but the best. Read more about how VCA's team of veterinary surgeons can help your pet survive veterinary surgery.

While your general practitioner veterinarian can diagnose and treat many health problems, certain diseases and conditions require the care of a doctor who has had specialized, intensive surgical training in order to provide the very best outcome for your pet. Your veterinary surgeon will work closely with your general practitioner veterinarian, as well as'"depending on your pet's condition'"other board certified specialists in internal medicine, veterinary oncology, veterinary neurology, and veterinary radiology.


Why Does My Pet Need A Veterinary Surgeon?

Just as your own primary care physician may feel the need to refer you to the care of a specialist from time to time, your general practitioner veterinarian may feel your pet needs the additional expertise of a board certified surgeon for certain surgeries. In fact, many general practitioner veterinarians refer all but the most routine of surgeries to specialists'"orthopedic and neurology cases, reconstructive surgeries, tumor removals, etc.

Board certified veterinary surgeons also are often affiliated with referral hospitals where they may have access to specialized diagnostic or surgical equipment, the latest and safest anesthesia monitoring equipment, physical therapy or rehabilitation capabilities, and other critical care services that a general practitioner may not have access to. All of these specialized services may be necessary for the optimal care and recovery of your pet.

You can be assured that a veterinarian who knows when to refer you and your pet to a veterinary surgeon is one that is caring and committed to ensuring that your pet receives the highest standard of care for his or her problem.

What Kinds of Problems Require the Expertise of a Veterinary Surgeon?

Board certified veterinary surgeons can repair complex fractures, perform total hip replacements, and use advanced techniques to repair torn ligaments (ruptured cruciate ligaments) within the knee. They can also remove cancerous growths, manage extensive or non-healing wounds, and perform reconstructive surgery, such as grafting skin over large injuries. Veterinary surgeons can perform intricate surgeries in the chest or abdomen, such as kidney transplants in cats or repairing heart defects in dogs. Spinal injuries and herniated discs are problems that are also commonly referred to board certified surgeons. Veterinary surgery is also expanding into minimally invasive surgery, such as arthroscopy, thorascopy, and laparoscopy.


Will My Regular Veterinarian Still Be Involved?

In many if not most surgical cases, your regular veterinarian will still supervise your pet's veterinary care, especially if your pet is continuing to cope with a disease or chronic condition. It depends on your pet's particular disease and health problem, however. Typically, though, your general practitioner veterinarian will oversee many aspects of your pet's pre-op and post-op care, just as in human medicine. Recovery periods are often prolonged in many surgical cases, particularly in orthopedic surgery, and it is very important to follow your veterinary team's recommendations concerning at-home recovery guidelines for your pet, follow up care and appointments, as well as any rehabilitation that has been prescribed.

Did You Know?

Just as in humans, a pet's recovery from veterinary surgery can go more smoothly or even result in a better outcome with the addition of rehabilitation options. Many veterinary referral hospitals offer rehabilitation services, such as water therapy, physical therapy, and massage therapy, as an adjunct to surgical care.

If you think that your pet may be a candidate for veterinary surgery, talk to your general practitioner veterinarian, or find a board certified veterinary surgeon near you today.

Our Surgery Services

Advanced Anesthetic Monitoring
Bone and Joint Surgery
Bone Biopsy
Brain and Spinal Surgery

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