Focus On – Neurosurgery

Spinal Surgery: MasterClass in Decompressive Techniques

Instructor(s):

Dr. Ruta Noreikaite (LT)

Course Overview

Intervertebral disc disease is the most common spine condition in dogs and decompression of the spinal cord often the only treatment for regaining locomotory function. However, relatively few surgeons or neurologists feel confident performing spinal surgery. This hesitancy stems from several factors: First, neurosurgery requires a comprehensive neurological examination combined with accurate interpretation of diagnostic imaging to precisely locate the site of spinal compression. Second, there is a significant fear of causing harm to the spinal cord, particularly if the surgical approach or technique is not optimal. To help you overcome these challenges, I have invited two highly experienced neurosurgeons, Bianca Hettlich and Björn Meij, both renowned for their expertise in performing and teaching neurosurgery, to lead this MasterClass spinal surgery 1 on decompressive techniques with more than 50% of the time dedicated to hands-on exercises. Please note that, for those interested in stabilization techniques for spinal fractures or instability, these topics will be addressed in MasterClass spinal surgery 2.

Aims and learning outcomes
The goal of this MasterClass is to equip participants with the confidence and skills to perform the most common decompressive surgical procedures. Topics to be covered in this three-day MasterClass include a quick review of neurologic examination, of the imaging of the spine, and of the most relevant surgical spinal diseases of the dog. Decompressive procedures will be reviewed and afterwards performed by participants in a cadaver lab. The course will also address procedural complications and postoperative management.

At the end of this course, participants will be able to:
o Interprete findings of the neurologic examination for spinal lesion localization and assessment of severity.
o Appraise pros and cons of different imaging modalities for assessment of spinal conditions.
o Choose appropriate technique and instrumentation for decompressive spinal surgery.
o Describe the different steps of decompressive procedures of cervical spine, thoracolumbar spine and lumbosacral spine.
o Apply skills to perform hemilaminectomy, mini-hemilaminectomy, lateral corpectomy, dorsal laminectomy, microdiscectomy, ventral slot and dorsal laminectomy.
o Recognize and manage possible intraoperative and postoperative complications
o Develop a postoperative management plan for patients after spinal decompressive surgery.

This course is designed for veterinary surgeons with interest in neurosurgery. Participants should be comfortable in conducting comprehensive neurological examinations and determining neurolocalization before attending the MasterClass. ECVN, ECVS, and ACVS’ residents in training are warmly invited to participate.

Course Program (Subject to change)