Current techniques in canine and feline neurosurgery

273 Pages·2017·19.719 MB·English

by  Brisson, Brigitte A., Shores, Andy

Current Techniques
in Canine and Feline
Neurosurgery
To my many mentors who shaped the direction of my career and planted many seeds that every day
yield the fruits of their tutelage: Drs. Frank Hoerlein, Charlie Knecht, Steve Swaim, John Oliver, Ralph
Henderson, Jimmy Milton, Bill Carney, Dick Redding, Don Sorjonen, Steve Simpson, and Paul Cechner –
your teachings shaped me and continue to inspire me every day.
To all the surgery and neurosurgery residents I have had the pleasure of teaching and mentoring –
passing the flames of this exciting profession and knowing your talents will be the new and exciting
blossoms of the future of veterinary neurosurgery.
To all my family – my parents that afforded me every opportunity to pursue my profession; to my
children, for all the smiles you’ve given me, for keeping me young, and for keeping me on my toes;
to my grandchildren that show me there is hope for the future; and to my wife Jessy, gracias por todo,
mi amor.
Andy Shores
To my husband Sean, for his incredible patience and unwavering support, which allow me to do what
I love and to reach my dreams. You are my rock.
To my wonderfully inspiring and beautiful daughter Julia who brings so much joy, laughter and balance
to my life. You never cease to amaze me. You are my world.
To the residents, interns and veterinary students I have had the privilege to teach and learn from. You
motivate me to push further every day and remind me that there is always something new and exciting
to learn.
To Dr. David Holmberg who was an incredibly talented surgeon and a wonderful mentor and colleague.
Thank you for teaching me so much about neurosurgery and inspiring me to seek the answers to what
I don’t yet know. You are greatly missed.
Brigitte A. Brisson
Current Techniques
in Canine and Feline
Neurosurgery
Edited by
Andy Shores
Neurosurgery and Neurology
Mississippi State University College of Veterinary Medicine and
The Veterinary Specialty Center
Mississippi State / Starkville
Mississippi, USA
and
Brigitte A. Brisson
Professor of Small Animal Surgery
Department of Clinical Studies
Ontario Veterinary College
University of Guelph, Guelph
Ontario, Canada
This edition first published 2017
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The right of Andy Shores and Brigitte A. Brisson to be identified as the authors of the editorial material in this work has been
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The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended
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Library of Congress Cataloging‐in‐Publication Data
Names: Shores, Andy, 1952– editor. | Brisson, Brigitte A., 1973– editor.
Title: Current techniques in canine and feline neurosurgery / edited by Andy Shores and Brigitte A. Brisson.
Description: Hoboken, NJ : John Wiley & Sons, Inc., 2017. | Includes bibliographical references and index. |
Identifiers: LCCN 2017025970 (print) | LCCN 2017027047 (ebook) | ISBN 9781118711460 (pdf) |
ISBN 9781118711521 (epub) | ISBN 9781118433287 (cloth)
Subjects: | MESH: Neurosurgical Procedures–veterinary | Dogs–surgery | Cats–surgery
Classification: LCC SF913 (ebook) | LCC SF913 (print) | NLM SF 981 | DDC 636.089/7–dc23
LC record available at https://lccn.loc.gov/2017025970
Cover images: courtesy of Andy Shores. For more details, please see the figure captions in chapter 11 for (left) Figure 11.9,
(middle) Figure 11.3A–D, and (right) Figure 11.1.
Cover design by Wiley
Set in 9/11pt Minion by SPi Global, Pondicherry, India
10 9 8 7 6 5 4 3 2 1
Contents
Contributors, vii 12 Suboccipital Craniectomy/Foramen Magnum
Decompression, 115
ACVS Foreword, ix
Erin Y. Akin and Andy Shores
ACVIM Foreword, xi
13 Surgical Treatment of Skull Tumors, 121
About the Companion Website, xiii
Michelle Oblak and Andy Shores
14 Shunt Placement and Marsupialization in Treatment
Section I: Diagnostics and Planning
of Hydrocephalus and Quadrigeminal Diverticula, 129
1 Neurosurgical Instrumentation, 3 William Thomas and Jill Narak
Michelle Oblak and Brigitte A. Brisson
2 Orthopedic Implants in Neurosurgery, 11 Section III: Spinal Procedures
Noel M.M. Moens
15 Atlantoaxial Subluxation, 141
3 Minimum Database for Intracranial Surgery, 21
Fred Wininger
Theresa E. Pancotto
16 Dorsal Cervical Decompression (Laminectomy/
4 Advanced Imaging: Intracranial Surgery, 29
Hemilaminectomy and Laminotomy), 149
Simon Platt and J. Fraser McConnell
James M. Fingeroth
5 Cisternal Cerebrospinal Fluid Taps, 55
17 Ventral Cervical Decompression, 157
Nora Ortinau
Ronaldo C. da Costa
6 Minimum Database: Spinal Surgery, 59
18 Lateral Cervical Approach, 163
Luis Gaitero and Brigitte A. Brisson
Amy Fauber and Robert Bergman
7 Advanced Imaging: Spinal Surgery, 71
19 Cervical Distraction and Stabilization, 169
Stephanie Nykamp
Bianca Hettlich
8 Lumbar Cerebrospinal Fluid Taps, 85
20 Thoracolumbar Hemilaminectomy, 179
Luis Gaitero
Andy Shores
9 Muscle and Nerve Biopsy, 93
21 Pediculectomy/Mini‐Hemilaminectomy, 183
Michaela Beasley
Brigitte A. Brisson
22 Intervertebral Disc Fenestration, 191
Section II: Intracranial Procedures Brigitte A. Brisson
10 Transfrontal Craniotomy, 99 23 Thoracolumbar Lateral Corpectomy, 199
Ane Uriarte and Rodolfo Cappello Pierre Moissonnier
11 Lateral (Rostrotentorial) Craniotomy/Craniectomy, 109 24 Dorsal Laminectomy in the Thoracolumbar Region, 205
Andy Shores Cory Fisher and Andy Shores
v
vi Contents
25 Vertebral Fracture and Luxation Repair, 209 Section IV: Postoperative Care and Rehabilitation
Bianca Hettlich
28 Guidelines for Postoperative Medical Care
26 Lumbosacral Decompression and of the Neurosurgical Patient, 245
Foraminotomy, 223 Debbie Reynolds and Brigitte A. Brisson
Trevor Bebchuk 29 Physical Rehabilitation of the Neurological Patient, 257
María Pérez Hernández and Ruby Lynn Carter
27 Surgical Management of Spinal
Neoplasia, 235
Mark S. Levy Index, 269
Contributors
Editors Amy Fauber Stephanie Nykamp
Purdue University, School of Veterinary Medicine, University of Guelph, Ontario Veterinary College,
Department of Clinical Science, West Lafayette, Indiana, Guelph, Ontario, Canada
Andy Shores
USA
Mississippi State University College of Veterinary Medi-
cine and the Veterinary Specialty Center, Mississippi Michelle Oblak
State / Starkville, Mississippi, USA James M. Fingeroth University of Guelph, Ontario Veterinary
Orchard Park Veterinary Medical Center, Orchard College, Guelph, Ontario, Canada
Brigitte A. Brisson Park, New York, USA
University of Guelph, Ontario Veterinary College, Nora Ortinau
Guelph, Ontario, Canada Cory Fisher VCA Aurora Animal Hospital, Aurora, Illinois,
Bluff City Veterinary Specialists Memphis, USA
Chapter Authors Tennessee, USA
Theresa E. Pancotto
Erin Y. Akin Luis Gaitero Virginia Tech, VA‐MD Regional College of
University of Guelph, Ontario Veterinary College, Veterinary Medicine, Blacksburg, Virginia, USA
Bush Veterinary Neurology Service, Woodstock,
Guelph, Ontario, Canada
Georgia, USA
María Pérez Hernández
Michaela Beasley Bianca Hettlich Mississippi State University, College of
Ohio State University, College of Veterinary Medicine, Veterinary Medicine, Mississippi State, Mississippi,
Mississippi State University, College of Veterinary
Department of Clinical Science, Columbus, Ohio, USA
Medicine, Mississippi State, Mississippi, USA
USA
Simon Platt
Trevor Bebchuk
Mark S. Levy Watkinsville, Georgia, USA
Great Plains Veterinary Surgery, Winnipeg, Manitoba,
NYC Veterinary Specialists, New York, New York, USA
Canada
Debbie Reynolds
Robert Bergman J. Fraser McConnell Toronto Veterinary Emergency Hospital,
Carolina Veterinary Specialists, Charlotte, North University of Liverpool, Small Animal Teaching Hospi- Scarborough, Ontario, Canada
Carolina, USA tal, Leahurst, Neston, Wirral, UK
William Thomas
Rodolfo Cappello Noel M.M. Moens University of Tennessee, Small Animal Clinical
North Downs Specialist Referrals, Brewerstreet Dairy University of Guelph, Ontario Veterinary College, Sciences, College of Veterinary Medicine, Knoxville,
Business Park, Bletchingley, Surrey, UK Guelph, Ontario, Canada Tennessee, USA
Ruby Lynn Carter Pierre Moissonnier Ane Uriarte
Mississippi State University, College of Veterinary Service de Chirurgie de L’enval Fort, Pole Chirugical du Cummings School of Veterinary Medicine,
Medicine, Mississippi State, Mississippi, USA Chuva Chirurgie, France Tufts University, North Grafton,
Tennessee, USA
Ronaldo C. da Costa Jill Narak
Ohio State University, Veterinary Medical Center, Veterinary Referral Surgical Practice, Roswell, Georgia, Fred Wininger
Columbus, Ohio, USA USA Columbia, Missouri, USA
vii
ACVS Foreword
The American College of Veterinary Surgeons Foundation is surgical training of residents and veterinary students; and bettering
excited to present Current Techniques in Canine and Feline animal patients’ care, treatment and welfare.
Neurosurgery. The ACVS Foundation is an independently charted Current Techniques in Canine and Feline Neurosurgery is edited
philanthropic organization devoted to advancing the charitable, by Drs. Andy Shores and Brigitte Brisson. Both are well recognized
educational, and scientific goals of the American College of as experts in this field. They have chosen strong contributing
Veterinary Surgeons. Founded in 1965, the ACVS sets the standards authors to detail the areas of diagnostics and planning, intracranial
for the specialty of veterinary surgery. The ACVS, which is approved and spinal surgery, and postoperative care and rehabilitation. We
by the American Veterinary Medical Association, administers the are sure you will find this reference extremely valuable.
board certification process for Diplomates in veterinary surgery The ACVS Foundation is proud to partner with Wiley Blackwell
and advances veterinary surgery and education. One of the princi- and the American College of Veterinary Medicine, and is honored
pal goals of the ACVS Foundation is to foster the advancement of to present this book.
the art and science of veterinary surgery. The Foundation achieves
these goals by supporting investigations in the diagnosis and treat- R. Randy Basinger
ment of surgical diseases; increasing educational opportunities for Chair, Board of Trustees
surgeons, surgical residents and veterinary practitioners; improving ACVS Foundation
ix
ACVIM Foreword
The American College of Veterinary Internal Medicine (ACVIM) vant to ACVIM specialties for the benefit of improved animal
advances knowledge of animal health and diseases, and fosters and human health.
the continued development of specialty veterinary care in large Drs. Andy Shores (an ACVIM (Neurology) Diplomate) and
animal internal medicine, small animal internal medicine, cardi- Brigitte Brisson (an ACVS Diplomate) have collaborated on this
ology, neurology, and medical oncology. To achieve these pur- issue to create a text which provides expertise from members of
poses, the ACVIM certifies new Diplomates by guiding training both veterinary specialty colleges. The ACVIM is proud to partner
programs, and ensuring fair and appropriate credentialing and with the ACVS Foundation and with Wiley Blackwell to present this
examination procedures; promotes and advocates veterinary book.
specialization; promotes continuing education and the dissemi-
nation of knowledge in veterinary cardiology, large animal inter- Charles Vite
nal medicine, small animal internal medicine, neurology, and President, Neurology Specialty
oncology; and promotes the generation of new knowledge rele- American College of Veterinary Internal Medicine
xi
About the Companion Website
This book is accompanied by a companion website:
www.wiley.com/go/shores/neurosurgery
The website features the following video clips:
Video 5.1 A cerebrospinal fluid (CSF) tap performed on a dog in lateral recumbency, using a 22G, 1-1/2 inch spinal needle.
Video 10.1 The transfrontal craniotomy approach is demonstrated in this video, using a sagittal to remove a diamond shaped section of
the frontal bone over the frontal sinus (video courtesy of Dr. Ane Uriarte).
Video 12.1 A suboccipital craniectomy is performed in a patient with Chiari malformation.
Video 13.1 A cotton tip applicator is used to free the bone segment from the dura for removal of the tumor and surrounding normal bone en-bloc.
Video 13.2 Rotational view of a preoperative 3D CT reconstruction of a dog with cranial tumour. The image can be manipulated in
multiple planes to assist in preoperative visualization and planning.
Video 15.1 A modified right parasagittal ventral surgical approach and placement of transarticular screws for the surgical management of
atlantoaxial subluxation in the canine are demonstrated (video courtesy of Dr. Fred Wininger).
Video 20.1 Part I The dorsolateral approach to the thoracolumbar spine is demonstrated in this video. In Part I, rongeurs are used to
create a left-sided hemilaminectomy at L1-L2 on a small canine patient. In Part II, a nitrogen powered burr drill is used to
create the hemilaminectomy at L1-L2 in a larger canine patient.
Video 21.1 Pediculectomy performed at T13-L1 through a dorsolateral approach on the left side (entire procedure).
Video 21.2 Modified dorsolateral surgical approach for pediculectomy.
Video 21.3 Following the initial approach through a dorsolateral incision, the spinal musculature is elevated using a periosteal elevator to
identify the appropriate site for pediculectomy at T13-L1 on the left.
Video 21.4 An air drill is used to create a pediculectomy for removal of herniated disc material from the spinal canal.
Video 21.5 After drilling through cortical, medullary and inner cortical bone, the spinal canal is entered by removing the remaining, thin
inner periosteum using an iris spatula or 90 degree bent needle and #11 blade.
Video 21.6 Opening of the remaining thin inner periosteal bone and removal of herniated disc material and hemorrhage from the spinal
canal using an iris spatula.
Video 21.7 Using a bent iris spatula to retrieve herniated disc material from the spinal canal. The spatula is manipulated from craniodorsal and
dorsocaudal toward the mid section of the pediculectomy ventrally to avoid pushing disc away from the pediculectomy window.
Video 21.8 Surgical closure of the modified dorsolateral approach used for pediculectomy.
Video 22.1 Blade fenestration performed at T13-L1 on the left following a pediculectomy procedure.
Video 24.1 Surgery is performed on a young, paralyzed canine patient with a gun projectile lodged in the dorsal aspect of the spinal canal at
the T12-T13 junction. A modified dorsal laminectomy is performed at that site to both remove the projectile and decompress the
spinal cord.
Video 29.1 Therapeutic exercises used in the rehabilitation of canine patients with neurologic diseases are demonstrated with commen-
tary on the benefits of each exercise and the recommended number of repetitions for each procedure.
xiii