Assistant Professor College of Veterinary Medicine, University of Missouri Columbia, Missouri
Vertebral osteosarcoma is the most common vertebral tumor in dogs. Palliative surgery combined adjunctive therapy improves outcomes significantly. However, the conventional surgery is associated with approach related morbidities including additional stabilizations. Recent advances in mini-open technique provide comparable outcomes but decrease morbidities of conventional procedures. This case study reports the successful outcome of the use of minimally invasive neurosurgery in a dog with a vertebral osteosarcoma. A 9-year-old, male castrated, mixed breed dog presented with non-ambulatory paraparesis and lumbar pain; advanced images revealed a vertebral mass at the level of L5. A mini-open lateral approach was used to access the target lesion. An integrated endoscopic system was used to perform a mini-hemilaminectomy for decompression and biopsy sampling. Clinically, no immediate post-operative neurological deterioration was observed, and ambulation was regained 2 days after surgery. No perioperative complications were reported. Intravenous opioid was limited to 24 hours postoperatively. Focal swelling was noted around incision for 2 days, and hospitalization was 3 days. Histopathology was consistent with osteosarcoma. At 2 weeks postoperatively, chemotherapy and definitive radiation therapy (RT) were initiated and completed. At 8 weeks postoperatively, neurologic examination was normal. The procedure can be performed safely, reduces recovery time with minimum morbidities and early neurological improvement. A large cohort study is required to evaluate the benefits and limitations of the technique. This case provides evidence that minimally invasive approach is an effective option especially when further oncological treatment is planned and potentially allows earlier administration of post-operative RT and chemotherapy.
