Electromyographic Evaluation of Early Stage Results of Exoscopic Microdecompressive Spinal Surgery in Dogs

Hakan Salci, Hilal Acar, Mevlut Ozgur Taskapilioglu


Background: Spinal surgical interventions are generally used in the treatment of various spinal pathologies such as vertebral fracture, luxation-subluxation, congenital vertebral deformities, discal hernia, infection and tumor. Minimally invasive spinal surgery contributes to rapid recovery by reducing iatrogenic muscle damage and postoperative pain. In minimally invasive spinal surgery, a new hybrid imaging technique, the exoscope, has been developed in the last decade The purpose of this study was to report efficacy of the exoscopic microdecompressive spinal surgery (MDSS) and its early postoperative electromyography (EMG) results in dogs.

Materials, Methods & Results:The material of this study consisted of the owned 10 dogs with spinal cord injury resulted from the different etiologies. On the basis of examinations, medical support (fluid therapy, corticosteroid, etc.) was applied to the required dogs. Exoscopic MDSS was performed under general anesthesia in dogs. The neurologic, radiologic and EMG examination were completed at pre- and postoperative periods. EMG results at postoperative 1st week showed increased conduction velocity and amplitudes in 3 cases. There was no significant change in a case. And, there was a slight slowdown in conduction velocity and significant decrease in amplitudes in a case. At postoperative 4th week, ther was increased conduction velocity and amplitudes in 8 cases and needle EMG showed that spontan muscle activity was normal in 5 cases, mild in 2 cases, moderate a case and severe in a case. But spontan muscle activity was unfollowed in a case. Postoperative outcomes were poor in 3 cases, fair in 3 cases, good in 3 cases and unfollowed in a case. 

Discussion: Spinal cord injuries encountered in veterinary medicine have significant morbidity and mortality. In spinal patients, in addition to neurological examination, lesion localization can be determined using imaging techniques such as radiology, computed tomography, and MRI. EMG and somatosensory evoked potentials examinations are used to evaluate quantitative functional recovery, especially in spinal cord injuries. EMG also provides an opportunity to evaluate muscle activation patterns during recovery. Exoscopic spinal surgery is the newest hybrid imaging technique. Exoscopic MDSS facilitated manipulation by providing adequate illumination and vision at the exploration site. Exoscopic MDSS has the advantages of microscopic surgery and is a new technique that can be applied in dogs with spinal pathology.

Full Text:



Beez T., Munox-Bendix C., Beseoglu K., Steiger H.J. & Ahmadi S.A. 2018. First clinical applications of a high-definition three-dimensional exoscope in pediatric neurosurgery. Cureus. 10(1): e21018.

Bergknut N., Smolders L.A., Grinwis G.C., Hagman R., Lagerstedt A.S., Hazewinkel H.A., Tryfonidou M.A. & Meij B.P. 2013. Intervertebral disc degeneration in the dog. Part 1: Anatomy and physiology of the intervertebral disc and characteristics of intervertebral disc degeneration. The Veterinary Journal. 195(3): 282-291.

Calancie B., Molano M.R. & Broton J.G. 2004. EMG for assessing the recovery of voluntary movement after acute spinal cord injury in man. Clinical Neurophysiology. 115(8): 1748-1759.

Calancie B., Molano M.R. & Broton J.G. 2004. Tendon reflexes for predicting movement recovery after acute spinal cord injury in humans. Clinical Neurophysiology. 115(10): 2350-2363.

Can P. & Beşaltı Ö. 2016. Omurilik hasarında güncel tedavi yöntemleri. Türkiye Klinikleri Veteriner Bilimleri - Cerrahi - Özel Konular. 2(3): 45-49.

Dewey C.W. 2013. Neurosurgery. In: Fossum T.W. (Ed). Small Animal Surgery. Philadelphia: Elsevier Mosby, pp.1411-1565.

DiFazio J. & Fletcher D.J. 2013. Updates in the management of the small animal patient with neurologic trauma. Veterinary Clinics of North America: Small Animal Practice. 43(4): 915-940.

Eminaga S., Palus V. & Cherubini G.B. 2011. Acute spinal cord injury in the cat, causes, treatment and prognosis. Journal of Feline Medicine and Surgery. 13(11): 850-862.

Garosi L. 2012. Examining The Neurological Emergency. In: Platt S. & Garosi L. (Eds). Small Animal Neurological Emergencies. London: Manson Publishing, pp.15-35.

Haider G., Akhtar S., Waqas M., Nizamani W., Jasmine A. & Enam S.A. 2018. Use of neuro-robotic exoscope for neurosurgery in Pakistan: A cases. Journal of Neurology and Neuroscience. 9(1): 241. doi: 10.21767/2171-6625.1000241

Henke D., Vandevelde M., Doherr M.G., Stöckli M. & Forterre F. 2013. Correlations between severity of clinical signs and histopathological changes in 60 dogs with spinal cord injury associated with acute thoracolumbar intervertebral disc disease. The Veterinary Journal. 198(1): 70-75.

Higginbithom M.J., Lanz O.I. & Carozzo C. 2015. Minimal Invasive Techniques for Spinal Cord and Nerve Root Decompression. In: Fingeroth J.M. & Thomas W.B. (Eds). Advences in Intervertebral Disc Disease in Dogs and Cats. Philadelphia: Wiley Blackwell, pp.289-293.

Holly L.T., Moftakhar P., Khoo L.T., Wang J.C. & Shamie N. 2007. Minimally invasive 2-level posterior cervical foraminotomy preliminary clinical results. Journal of Spinal Disorders & Techniques. 20(1): 20-24.

Jeffery N.D., Levine J.M., Olby N.J. & Stein V.M. 2013. Intervertebral disc dejeneration in dogs: consequences, diagnosis, treatment, and future directions. Journal of Veterinary Internal Medicine. 27(6): 1318-1333.

Kirby R. 2010. Emergency management of spinal cord lesions. Clinician’s Brief. 27-32.

Mamelak A.N., Danielpour M., Black K.L., Hagike M. & Berci G. 2008. A high-definition exoscope system for neurosurgery and other microsurgical disciplines: preliminary report. Surgical Innovation. 15(1): 38-46.

Mamelak A.N., Drazin D., Shirzadi A., Black K.L. & Berci G. 2012. Infratentorial supracerebellar resection of a pineal tumor using a high definition video exoscope (VITOM). Journal of Clinical Neuroscience. 19: 306-309.

Mamelak A.N., Nobuto T. & Berci G. 2010. Initial clinical experience with a high-definition exoscope system for microneurosurgery. Neurosurgery. 67(2): 476-483.

Mikhael M.M., Celestre P.C., Wolf C.F., Mroz T.E. & Wang J.C. 2012. Minimally invasive cervical spine foraminotomy and lateral mass screw placement. Spine. 37(5): 318-322.

Nishiyama K. 2017. From exoscope into the next generation. Journal of Korean Neurosurgical Society. 60(3): 289-293.

Okuno S., Kobayashi T. & Orito K. 2005. Usefulness of combined electrophysiological examinations for detection of neural dysfunction in cats with lumbar hematomyelia. The Journal of Veterinary Medical Science. 67(12): 1265-1268.

Olby N., Levine J., Harris T., Munana K., Skeen T. & Sharp N. 2003. Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001). Journal of the American Veterinary Medical Association. 222(6): 762-769.

Park E.H., White G.A. & Tieber L.M. 2012. Mechanisms of injury and emergency care of acute spinal cord injury in dogs and cats. Journal of Veterinary Emergency and Critical Care. 22(2):160-178.

Penning V., Platt S.R., Dennis R., Cappello R. & Adams V. 2006. Association of spinal cord compression seen on magnetic resonance imaging with clinical outcome in 67 dogs with thoracolumbar intervertebral disc extrusion. Journal of Small Animal Practice. 47(11): 644-650.

Rabinowitz R.S., Eck J.C., Harper Jr. C.M., Larson D.R., Jimenes M.A., Parisi J.E., Friedman J.A., Yaszemski M.J. & Currier B.L. 2008. Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury. Spine. 33(21): 2260-2268.

Ricciardi L., Chaichana K.L., Cardia A., Stifano V., Rossini Z., Olivi A. & Sturiale C.L. 2019. The exoscope in neurosurgery: an innovative “point of view”. A systematic review of the technical, surgical, and educational aspects. World Neurosurgery. 124: 136-144.

Sharp N.J.H. & Wheeler S.J. 2005. Small Animal Spinal Disorders. 2nd edn. London: Elsevier Mosby, pp. 57-61.

Shih P., Wong A.P., Smith T.R., Lee A.L. & Fessler R.G. 2011. Complications of open compared to minimally invasive lumbar spine decompression. Journal of Clinical Neuroscience. 18(10): 1360-1364.

Shores A. & Brisson B.A. 2017. Current Tecniques in Canine and Feline Neurosurgery. Philadelphia: Wiley Blackwell, pp.141-235.

Skovrlj B., Gilligan J., Cutler H.S. & Qureshi S.A. 2015. Minimally invasive procedures on the lumbar spine. World Journal of Clinical Cases. 3(1): 1-9.

Thomson C. & Hahn C. 2012. Veterinary Neuroanatomy: A Clinical Approach. Saint Louis: Saunders Elsevier, pp.124-136.

van Nes J.J. 1986. An introduction to clinical neuromuscular electrophysiology. Veterinary Quarterly. 8(3): 233-239.

van Nes J.J. 1986. Clinical application of neuromuskuler electrophysiology in the dog: a review. Veterinary Quarterly. 8(3): 240-250.

Yang S.M., Park H.K., Chang J.C., Kim R.S., Park S.Q. & Cho S.J. 2013. Minimum 3-year outcomes in patients with lumbar spinal stenosis after bilateral microdecompression by unilateral or bilateral laminotomy. Journal of Korean Neurosurgical Society. 54(3): 194-200.

Yaygıngül R. & Belge A. 2016. Köpeklerde intervertebral disk hastalığı. Türkiye Klinikleri Veteriner Bilimleri - Cerrahi - Özel Konular. 2(3): 60-67.

DOI: https://doi.org/10.22456/1679-9216.101278

Copyright (c) 2020 Hakan Salci, Hilal Acar, Mevlut Ozgur Taskapilioglu

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.