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Distraction Stabilization of Degenerative Lumbosacral Stenosis: Technique and Mid- to Long-Term Outcome in 30 Cases – Lumbar Spinal Stenosis

This article describes a surgical technique, known as dorsal laminectomy, annulectomy, and distraction stabilization, for the management of canine degenerative lumbosacral stenosis. The study aimed to evaluate the complications and outcomes of this technique, as well as changes in foraminal width and vertebral step. The medical records of 30 dogs treated between 2005 and 2020 were examined. The results showed that most dogs experienced clinical improvement and reduced pain scores after surgery. However, there were a few cases of catastrophic complications and major complications that required additional surgery. The study also found that the procedure significantly increased foraminal width and reduced lumbosacral step defect. The authors concluded that this complex procedure can be beneficial for improving gait characteristics and reducing pain in dogs with lumbosacral stenosis, but it should be performed by experienced surgeons

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spine centre in the world

Published article

OBJECTIVE: To describe the dorsal laminectomy, annulectomy and distraction stabilization with pins and polymethylmethacrylate technique, its complications and outcome in the management of canine degenerative lumbosacral stenosis. To determine pre- and post-surgical foraminal width and vertebral step changes.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Vet Comp Orthop Traumatol. 2021 Nov;34(6):427-436. doi: 10.1055/s-0041-1735647. Epub 2021 Oct 1.ABSTRACTOBJECTIVE: To describe the dorsal laminectomy, annulectomy and distraction stabilization with pins and polymethylmethacrylate technique, its complications and outcome in the management of canine degenerative lumbosacral stenosis. To determine pre- and post-surgical foraminal width and vertebral step changes.STUDY DESIGN: Multi-institutional retrospective clinical study.METHODS: Medical,

Vet Comp Orthop Traumatol. 2021 Nov;34(6):427-436. doi: 10.1055/s-0041-1735647. Epub 2021 Oct 1.

ABSTRACT

OBJECTIVE: To describe the dorsal laminectomy, annulectomy and distraction stabilization with pins and polymethylmethacrylate technique, its complications and outcome in the management of canine degenerative lumbosacral stenosis. To determine pre- and post-surgical foraminal width and vertebral step changes.

STUDY DESIGN: Multi-institutional retrospective clinical study.

METHODS: Medical records (2005-2020) of dogs treated (n = 30). Clinical signs, Modified Frankel Score, Texas Spinal Cord Injury Score, pain score (dorsal palpation of spine, tail dorsiflexion), imaging findings and complications were retrieved pre-operatively, perioperatively and at long-term follow-up.

RESULTS: The most common presurgical imaging findings were disc protrusion (24/25) and sclerosis of the caudal end-plate of L7 (23/30). On short- to long-term assessment 18 out of 21 dogs exhibited clinical improvement and all exhibited improved pain scores (p < 0.0001). Catastrophic complications occurred in 3 dogs, and major complications occurred in 5, of which 3 required additional surgery. Mean lumbosacral step defect reduced 60% (1.8 mm ± 2.5 mm pre-surgery to 0.7mm ± 0.9mm post-surgery, p = 0.1585). Mean foraminal width significantly increased 50% long-term (3.3 mm ± 1.0 mm pre-surgery to 5.0 mm ± 0.9 mm post-surgery, p < 0.0001).

CLINICAL SIGNIFICANCE: Dorsal laminectomy, annulectomy and distraction stabilization is a complex procedure which can significantly increase foraminal width, reduce pain and improve gait characteristics in dogs in the short- to long-term, and should be performed by surgeons experienced in lumbosacral pin placement.

PMID:34598302 | DOI:10.1055/s-0041-1735647

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Distraction Stabilization of Degenerative Lumbosacral Stenosis: Technique and Mid- to Long-Term Outcome in 30 Cases

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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Vet Comp Orthop Traumatol. 2021 Nov;34(6):427-436. doi: 10.1055/s-0041-1735647. Epub 2021 Oct 1.ABSTRACTOBJECTIVE: To describe the dorsal laminectomy, annulectomy and distraction stabilization with pins and polymethylmethacrylate technique, its complications and outcome in the management of canine degenerative lumbosacral stenosis. To determine pre- and post-surgical foraminal width and vertebral step changes.STUDY DESIGN: Multi-institutional retrospective clinical study.METHODS: Medical

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