Hemilaminectomy following Hansen type 1 IVDD

Intervertebral disc prolapse Hansen type I ” Disc Extrusion” & Hemilaminectomy Case

History:

• A 2- years Griffon dog (Taper) was admitted to our clinic, Elite Veterinary Clinic (Riyadh, KSA) with acute onset of hind limb paralysis, urine retention & Constipation.
• History of sudden crying at the garden after a sudden movement followed by recumbency and paralysis.

The Neurological examination reveals the following:

• Increased patellar reflex if both HL (+3)
• Normal Flexor reflex of both HL (+2)
• Reduced cranial tibial reflex of both HL (+1)
• Normal sciatic reflex of both HL (+3)
• Normal perineal reflex (+2)
• Absent proprioception (0) with Knuckling of both hind limbs.
• Normal nociception “Deep pain sensation” (+2)
• Absent superficial cutaneous reflex caudal to the last rib at the left side.

Type and grade of neurological deficits:

• UMN deficit with Grade “4” , localized to T2-L4 spinal segments. Radiographic examination revealed no vertebral luxation or fracture.

Prognosis:

• Favorable prognosis with surgical interference (80% success rate in early surgical admission).

Suspected Diagnosis and Decision:

• Hansen type (1) Intervertebral disc disease was strongly suspected.

• C.T was recommended to accurately assess the cause of spinal nerves compression.

C.T reveals the following:

1. Disc extrusion (Hansen type I disc prolapse) located between T12 – T13 vertebrae.
2. Herniated disc compresses the spinal cord with 50%.
3. Herniated disc material occupies the left and right side ventrally with 70% of the herniated content at the left side.
4. Caudal migration of the herniated disc material.

Recommendations:

1. Hemilaminectomy surgical procedure to remove the herniated disc with expected recovery period up to 3 months.
2. Medical treatment (Neuro-vitamins, Gabapentin, Gastroprotection) for one month following surgery.
3. Cage restriction for six weeks following surgery.

Follow up videos reveal:

• Excellent recovery at 14th day after surgery with full legs function.
• Expected more improvement of the proprioception of the left leg (Video).