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.
Main Surgeon during Hemilaminectomy
During vertebral canal window widening by Kerrison needle

Follow up videos reveal:

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

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