Comparison of harmonic blade versus traditional approach in canine patients undergoing spinal decompressive surgery for naturally occurring thoracolumbar disk extrusion

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Authors

Hettlich, Bianca F.
Cook, Laurie
London, Cheryl
Fosgate, Geoffrey Theodore

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Publisher

Public Library of Science

Abstract

OBJECTIVES To assess feasibility of the harmonic Osteovue blade (HOB) for use in the soft tissue approach for dogs undergoing hemilaminectomy and to compare outcomes between dogs undergoing HOB or traditional approach (TRAD). METHODS A prospective randomized clinical trial was performed using 20 client-owned dogs with thoracolumbar intervertebral disk extrusion requiring hemilaminectomy. Dogs were randomly assigned to HOB or TRAD. Neurologic function and pain scores were assessed pre-operatively. Intraoperative blood loss and surgical approach time as well as postoperative pain and wound healing scores were recorded. Additionally, neurologic recovery and owner perceived quality of life were recorded at day 10 and 30 postoperative. RESULTS There was no significant difference in sex distribution, weight, age, preoperative neurological grade and pain score, and perioperative outcome measures between groups. Intraoperative total blood loss was minimal for HOB and TRAD (median: 0 ml (range 0±9) and 2.2 ml (range 0±6.8), respectively; p = 0.165) and approach times were similar (median: 7 min (range 5±12) and 8 min (range 5±13), respectively; p = 0.315). While changes in wound healing scores were similar, changes in postoperative pain scores and neurological function were significantly improved in the HOB compared to the TRAD group. Postoperative complications in the HOB group consisted of automutilation of part of the incision and development of a small soft, non-painful subcutaneous swelling in 1 dog each. CONCLUSIONS The HOB is a safe and effective tool for the soft tissue approach for routine spinal surgery in dogs and is associated with decreased pain and increased neurological function postsurgery.

Description

S1 File. Wound assessment form. Document to record various aspects of wound related factors for individual patients.
S2 File. Pain assessment form. Document to record various aspects of pain related factors for individual patients.
S1 Fig. Photographs of incisions of 1 TRAD and HOB dog. Examples of incision photographs of one dog with TRAD and one with HOB approach on day of surgery and 1, 2, and 3 days postoperatively.
S1 Data. Excel study data. Dataset of evaluated factors of all patients, including patient and surgery factors, neurologic grading, pain questionnaire and visual analog scores, incision healing scores, owner perceived neuro status and function, and quality of life factors.

Keywords

Soft tissue, Dogs, Harmonic Osteovue blade (HOB), Traditional approach (TRAD), Spinal decompressive surgery, Thoracolumbar disk extrusion

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Citation

Hettlich BF, Cook L, London C, Fosgate GT (2017) Comparison of harmonic blade versus traditional approach in canine patients undergoing spinal decompressive surgery for naturally occurring thoracolumbar disk extrusion. PLoS ONE 12(3): e0172822. DOI: 10.1371/journal.pone.0172822