Hemilaminectomy Thoracolumbar Disc Rupture

Many dogs especially the miniature dachshund suffer a ruptured, slipped or herniated intervetebral disc.  This can lead to paresis or weakness of the hind limbs and can be severe enough to cause paralysis.  
 

How to localize lesion and diagnose?

 
A neurological examination can localize the lesion and generate enough information to determine the next step.  Mildly affected dogs may get better with conservative treatment.  Conservative treatment can include the use of a muscle relaxant, steroids(prednisone) or a non steroidal medication.  The most important component of conservative treatment is exercise restriction.  Over activity can lead to an unsuccessful outcome. 

More severely affected dogs require advanced imaging which can include myelogram, CT scan or MRI.  While CT scans and MRI's can give great images and good information the vast majority of dogs can be diagnosed and treated based on a myelogram.  Myelography is more readily available and remains much less expensive than more advanced imaging. 

Myelogram

Once the lesion has been localized(determine the disc spaces affected) a surgical plan can be determined.  Imaging that indicate a spinal cord compression are best dealt with surgically.  If the lesion or disc is in the thoracolumbar spinal cord a procedure called a hemilaminectomy can be performed.  There are some cases that require a dorsal laminectomy but this is much less frequently employed. 

A hemilaminectomy is a procedure where the surgeon approaches the spinal column.  After determining the correct disc space a high speed drill with a bur is used to remove the lamina (vertebral bone) on either the right or left side of the vertebral bodies.  The removal of the bone allows the surgeon to visualize the spinal cord and the disc which facilitates removal of the disc material.  Once the spinal cord is decompressed it can begin the process of healing.  

The spinal cord will require some time to heal.  The healing process for every dog is different and can take several days to weeks to be complete.  Many dogs can have a complete recovery and return to normal function.  Some dogs will be left with some hind limb weakness that never abates.  There are some dogs that are so severely affected they do not require despite all our efforts.  Many times these dogs can be managed in a cart.
 

Hospitalization:


These patients require around the clock care.  They are best managed in a facility that can provide them with 24 hour care.  The more severely affected dogs will need to have their urinary bladder managed either through use of an indwelling catheter or expression.  Postoperative patients require pain management that can be administered around the clock.  

It is for this reason that I perform these surgeries at Veterinary Care Specialists in Milford, MI. 
 

Home Care:

  1. Exercise restriction is very important during the healing process.  These dogs should be confined to a small room or a crate when unsupervised.  This will allow them to remain safe and not overexert themselves in your absence. 
  2. Medications prescribed should be given as outlined in your discharge instructions.  These medications may include an antibiotic but will always include pain medication.  We should be alerted to any adverse reactions your dog may have to any of the prescribed medications.  These can be vomiting, diarrhea, inappetence just to list a few. 
  3. When taking your dog outside to the bathroom it would be best to employ a sling to help support their hind limbs while they are regaining their strength.  You may purchase a sling or employee a towel just in front of their.
  4. Your dog will have an incision which will need 10-14 days to heal.  You should monitor this closely for signs of infection:  redness, pain, swelling or oozing.  Should you have concerns you should call immediately. 
  5. Physical therapy can be very helpful while your dog is not ambulatory.  In the beginning passive range of motion is important.  Standing and rebuilding muscle strength.  Once the incision is healed swimming is very good.
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205 Rowe Rd Milford, MI 48380
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