What is Cervical Dorsal Laminectomy?
Cervical dorsal laminectomy is a surgical procedure which is used to decompress the cervical spinal cord, located in the neck. When a disc in the spinal cord “slips” or becomes herniated, it can compress the spinal cord, which can cause lameness and even paralysis. This procedure is considered more invasive than the cervical ventral slot technique, which is also used to decompress the cervical spinal cord following disc herniation. However, both techniques may be recommended for select cases of disc herniation.
Cervical Dorsal Laminectomy Procedure in Cats
There are a few different approaches to cervical dorsal laminectomy, and the approach used will vary based on the skill and expertise of the practicing surgeon as well as the location of the lesion. The general procedure steps for cervical dorsal laminectomy are outlined below.
- Prior to surgery, the cat will be evaluated for anesthetization and may be x-rayed.
- The cat will be anesthetized, given analgesics, and prepped for surgery. This may involve securing the cat in some way – either with a neck brace or towel, or securing the cat to a solid surface.
- Antibiotics will be administered intravenously throughout the procedure.
- The surgeon will first make a skin incision into the back of the neck.
- The subcutaneous tissues will be incised and the nuchal ligament will be exposed.
- The surgeon will separate the ligaments and muscles surrounding the spine along their natural seams to expose the vertebra that requires operation.
- A specialized drill will be used to remove the dorsal cortex and medullary bone so that the inner cortical layer of the vertebra is exposed.
- Portions of the lamina, the bony structure which protects the spinal cord, will be removed so that the spinal cord is visualized.
- The dorsal interarcuate ligament will be separated
- If the procedure is used to treat a hypertrophic ligament, the surgeon will now begin closing the surgery site.
- If IVDD is present, the disc material which is compressing the spinal cord will then be removed.
- The surgeon will ensure all disc material has been extracted before placing a fat graft over the site of the lamina.
- The surgeon will then suture the surgery site.
- The cat will be hospitalized for up to five days.
Efficacy of Cervical Dorsal Laminectomy in Cats
The efficacy of this procedure depends on the expertise of the surgeon as well as the condition it was used to treat. For most cases of IVDD, the prognosis is generally good. For cases of hypertrophic ligaments and cancerous lesions, the prognosis may vary depending on how severely the spinal cord was compressed and whether or not the condition is chronic.
Cervical Dorsal Laminectomy Recovery in Cats
Following cervical dorsal laminectomy, cats will need to be hospitalized for one to five days. During this time, the vet will monitor the cat’s condition and administer pain medications, antibiotics, and other medications as needed. While the cat is hospitalized, physical therapy will be employed to ensure full range of motion.
On the return home, cats should be confined to a small room or crate for up to four weeks following surgery, and should not engage in activity. Antibiotics and analgesics will be prescribed as needed. Owners should monitor their cats at all times. Cats may need assistance getting in and out of the litter box during the recovery period, so owners should make sure the litter box is easily accessible.
A follow-up appointment will be scheduled within ten to fourteen days following surgery to remove sutures. Additional follow-up appointments will be scheduled monthly for the first three months postoperatively, and then quarterly to monitor healing and neurological function. These appointments will be discontinued when no more improvement has been observed.
Cost of Cervical Dorsal Laminectomy in Cats
The average cost of cervical dorsal laminectomy will vary depending on standards of living and any additional costs incurred, including medications, laboratory testing, supportive care, and hospitalizations. The cost of cervical dorsal laminectomy typically ranges from$2,000 to $6,900.
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Cat Cervical Dorsal Laminectomy Considerations
Complications are considered rare with cervical dorsal laminectomy. However, complications are possible with all surgical procedures. Complications of cervical dorsal laminectomy include, but may not be limited to:
- Urinary tract infection (more common in bedridden cats)
- Seroma formation: the accumulation of fluid following surgery
- Damage to the venous sinus
- Neurological deterioration
- Recurrence of the condition
- Anesthetic death
With cervical dorsal laminectomy, there is less risk of damaging the venous sinus – which can result in hemorrhage and further complications – compared to the cervical ventral slot approach. Although hemorrhage is less common with the dorsal laminectomy approach, it is still possible. However, if hemorrhage occurs during dorsal laminectomy, it is easier for the surgeon to control it because this procedure allows for better visualization compared to the cervical ventral approach.
Cervical Dorsal Laminectomy Prevention in Cats
In some cases, it is difficult to prevent conditions that are treated by cervical dorsal laminectomy, particularly neoplasia and disc herniation. Owners should ensure their cats do not engage in activities that can cause trauma to the spine or spinal cord. Cats should be fed a complete commercial diet, and their weight should be monitored. Cats which have undergone cervical dorsal laminectomy should not be bred.