Minimal invasive surgical approach to thoracolumbar intervertebral disc disease

Since many years, thanks to video-assistance, minimally invasive techniques (coelioscopy, arthroscopy, thoracoscopy) have been developed in veterinary as in human surgery to reduce morbidity and to offer better cosmetic result. In human neurosurgery, the use of video assisted and mini-invasive procedures has been frequently reported since the early 90’s. In the veterinary literature, there has only been few published descriptions of a video-assisted technique for neurosurgery.

This document is an overview of neuro endoscopic techniques described in veterinary surgery.

Endoscope-Assisted Thoracolumbar Lateral Corpectomy (Carozzo C Vet Surg 2011). The objective of this study was to describe an endoscope-assisted lateral approach to expose the intervertebral disc and perform a lateral thoracolumbar corpectomy in dogs.

Results of this study were that the foramen and intervertebral disc were clearly observed in all specimens without any iatrogenic injury of the ventral and dorsal nerve branches. Access to the foramen was possible in all specimens; in the thoracic area the head of the rib was always partially excised to observe the intervertebral disc medially. Lateral corpectomy was easily performed in all cadavers and spinal cord observation was good. Extension to foraminotomy or mini hemilaminectomy could easily be performed through the same limited approach.

As a conclusion, endoscopic exploration provided a good viewing of the intervertebral disc and/or foramen. An endoscope-assisted thoracolumbar lateral corpectomy could effectively be performed through a limited approach to the thoracolumbar discs and allowed good ventral spinal cord assessment. [...]