Re-opening the window on fenestration in intervertebral disc disease.
Acute thoracolumbar intervertebral disc herniation is a common cause of ‘back’ pain, pelvic limb paresis or paralysis and incontinence in dogs. In an article published in the Journal of Small Animal Practice, our Official Scientific Journal, Paul Freeman and Nick Jeffery discuss the controversy that surrounds the treatment of this condition.
Treatment options for canine thoracolumbar disc herniation broadly fall into conservative or surgical categories. Unfortunately, formal clinical trials to compare the efficacy of conservative and surgical interventions have never been carried out. Freeman and Jeffery discuss the previously published data on recovery associated with the various therapies, focusing on evidence suggesting that decompressive surgery and fenestration may be equally efficacious. Although fenestration does not purport to reduce the compression on the spinal cord that results from the extruded disc, it is thought to reduce the risk of further extrusions from an already damaged annulus, thus preventing worsening of the clinical signs.
Whilst the authors do not propose abandoning the current treatment protocols for canine intervertebral disc disease, they conclude that it might be appropriate to consider comparing the rapidity and completeness of recovery following standard decompressive surgery versus that after multi-level fenestration in a large randomised clinical trial.
Read the full article.
JSAP has produced an online selection of international papers for members of the WSAVA Member Associations who do not already have access to the journal. Read the latest WSAVA ‘virtual issue’ of JSAP.