Advanced Techniques in Canine and Feline Neurosurgery

ISBN-13: 9781119790426 / Angielski / Twarda / 2023 / 256 str.

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List of Contributors xviiACVS Foreword xixACVIM Foreword xxiPreface xxiiiAbout the Companion Website xxv1 A History of Veterinary Neurosurgery: 1900-2000 1Don SorjonenIntroduction 1Advances in Imaging Techniques 1Advances in Spinal Procedures 2Thoracolumbar (T1-S1) 2Cervical (C1-C7) 5Advances in Intracranial Procedures 8Epilogue 11References 122 Applications of 3D Printing in Veterinary Neurosurgery 17Fred WiningerSteps of the 3D Printing Process 18Acquisition 18Thresholding 18Segmentation 18File Format Creation 19Manifold Manipulation 19Anatomic Modeling 19Printing 20Current Spinal Applications 20Customized Tools 20Current Brain Applications 21Future Applications of 3D Printing in Veterinary Neurosurgery 23References 233 Postoperative Radiation Therapy of Intracranial Tumors 25M. W. NolanIntroduction 25Overview of Radiation Therapy 25Radiobiology 25DNA as The Target for Radiation 25Normal Tissue Injury 26Rationale for Radiation Fractionation 26Radiation Physics and Treatment Planning 28Beam Energy Selection 28Dose Calculations 28Target Localization Strategies 29Delivery Systems 31Plan Evaluation 32Specific Tumor Types 33Meningioma 33Clinical Data 33Radiotherapeutic Techniques 34Glial Tumors 34Clinical Data 34Radiotherapeutic Techniques 35Choroid Plexus Tumors 35Clinical Data 35Radiotherapeutic Techniques 35Spinal Tumors 35Clinical Data 35Radiotherapeutic Techniques 36Stereotactic Radiosurgery and Stereotactic Radiation Therapy 36References 374 Practice and Principles of Neuroanesthesia for Imaging and Neurosurgery 39Claudio C. NataliniIntroduction 39Increases in ICP 39Clinical Signs 39Dynamics 39Cerebral Perfusion and Anesthesia 40The Cushing Reflex and Anesthesia 40Increases in ICP During Anesthesia 41ICP and Contrast Myelography 42Hydrocephalus 42Neurologic Monitoring: Monitoring Brain State During Anesthesia 42Modalities of Neurologic Monitoring 42Electroencephalogram EEG 42Sensory-Evoked Responses (SERs) and Somatosensory-Evoked Potentials (SSEPs) 42Glycemic Control 42Monitoring Nociception 42Other Modalities 43Sedation versus General Anesthesia for Imaging 43Regional Anesthesia for Laminectomy, Hemilaminectomy, and Vertebral Fractures 43Anesthesia Protocol for Intracranial Surgery 43References 44Part I Spinal Procedures 455 Cervical Ventral Slot Decompression 47Andy Shores and Allison MooneyCervical IVD Syndrome 47History 47Clinical Signs 47Radiographic Signs 48Advanced Imaging 49Indications for Surgery 50Ventral Approach to the Cervical Spine 50Decompression of the Cervical Spinal Cord 54Ventral Slot Method 54Perioperative and Postoperative Care 58References 586 Thoracolumbar Decompression: Hemilaminectomy and Mini-Hemilaminectomy (Pediculectomy) 59Brigitte A. BrissonIndications 59Procedures 59Technique: Surgical Approach for Mini-Hemilaminectomy (Video 6.1) 60Dorsolateral Approach [14-17] (Video 6.2) 60Variation 61Recommended Variation 61Technique: Mini-Hemilaminectomy Procedure 63Technique: Surgical Approach for Hemilaminectomy 64Technique: Hemilaminectomy Procedure 65Removal of Disk Material: Mini-Hemilaminectomy and Hemilaminectomy 66Closure 67Complications 67Postoperative Care 68References 687 Thoracolumbar Disk Fenestration 70Brigitte A. BrissonIndications 70Technique - Surgical Approach 71Variations 72Technique - Fenestration Procedure (Video 7.1) 72Blade Fenestration 73Power Fenestration 73Other Requirements 75Closure 75Complications 75Postoperative Care 76References 768 Percutaneous Laser Disk Ablation 78Danielle DugatIntroduction 78Laser Ablation 78Candidate Selection 79Procedure Description 80Procedure Complications and Recurrence 82Diagnostic Evaluation of PLDA 83Conclusion 84References 849 The Cranial Thoracic Spine: Approach via Dorsolateral Hemilaminectomy 86Yael Merbl and Annie Vivian Chen-AllenIndications 86Surgical Anatomy 87Patient Positioning 87Surgical Technique 88Postoperative Care 89References 9010 Principles in Surgical Management of Locked Cervical Facets in Dogs 91Andy Shores and Ryan GibsonIntroduction 91Unilateral Locked Cervical Facets in Humans 91Clinical Presentation 91Surgical Techniques 92Postoperative Care 94Summary/Conclusions 94References 9511 Spinal Stabilization: Cervical Vertebral Column 96Bianca F. HettlichIntroduction 96Preoperative Planning 96Anatomical Considerations 96Implant Selection 97Positioning and Approach 97Vertebral Distraction 98Diskectomy 99Intervertebral Spacer 99Indication for Additional Decompression 101Surgical Stabilization 101Monocortical Screw/PMMA Fixation 101Vertebral Body Plates 102Other Techniques 104Stabilization of Multiple Spaces 105Postoperative Assessment 105Complications 106References 10712 Stabilization of the Thoracolumbar Spine 109Simon T. Kornberg and Brigitte A. BrissonPreoperative Planning 109Decompression with Stabilization 111Technique 111Implant Selection 111Thoracolumbar Spine 114Positioning and Approach 114Implant Selection 114Spinal Stapling/Segmental Fixation 116Lumbosacral Spine 118Anatomy 118Positioning and Approach 118Reduction 119Implant Selection 119Postoperative Imaging 120Complications 120Aftercare 122Acknowledgments 122References 12213 Surgical Management of Congenital Spinal Anomalies 124Sheila Carrera-Justiz and Gabriel GarciaDiagnostics 124Treatment 125Prognosis 126Future Directions 127Summary 127References 12714 Lumbosacral Decompression and Foraminotomy Techniques 129Stef H. Y. Lim and Michaela BeasleyPathophysiology and Anatomy 129L7-S1 Foramina Anatomy 129Diagnosis 130History and Clinical Signs 130Physical Examination Findings 130Orthopedic Examination Findings 130Neurologic Examination Findings 131Radiography 131Myelography (Contrast Study) 132Computed Tomography (CT) 132Magnetic Resonance Imaging (MRI) 133Force Plate Analysis 134Electrodiagnostics 134Treatment: Conservative and Medical Therapy 134Surgery 134Dorsal Laminectomy 135Patient Preparation and Positioning 135Surgical Technique 135Foraminotomy 136Facetectomy 137Distraction, Fusion, and Stabilization 137Pins and PMMA 137SOP Plating 137Surgical Technique 138Pedicle Screw and Rod Fixation (PSRF) 138Minimally-Invasive Transilial Vertebral (MTV) Blocking 138Postoperative Management 139References 13915 Surgical Management of Spinal Nerve Root Tumors 143Ane UriarteIntroduction 143Clinical Presentations 143Meningioma 143Peripheral Nerve Sheath Tumors 143Diagnosis 144Imaging 144Spinal Meningioma MRI 144PNST MRI 144Electrodiagnostics 147Cytology/Histology 147Meningiomas 147PNST 147Surgery of PNST Within the Spinal Nerves 148Cervical Approach 148Positioning 148Lateral Surgical Approach to Caudal Cervical Foramen After Amputation 148Dorsal Surgical Approach for Cervical Hemilaminectomy 149Respiratory Compromise in Cervical Myelopathies 149Lumbar Approach 150Approach to the L7-S1 Foramen 150Postoperative Care 150Prognosis 151Radiation Therapy 151References 15116 Surgical Management of Craniocervical Junction Anomalies 153Sofia Cerda-GonzalezIndications 153Surgical Anatomy 154Patient Preparation and Positioning 155Surgical Technique 156Outcomes 159References 15917 Ventral Approach to the Cervicothoracic Spine 161Isidro MateoIntroduction 161Surgical Anatomy [10-12] 161Muscles 161Vessels 163Nerves 163Viscera 163Surgical Technique [10, 12] 163Clinical Results 165Conclusion 167References 167Part II Intracranial Procedures 16918 Intraoperative Ultrasound in Intracranial Surgery 171Alison M. Lee, Chris Tollefson and Andy ShoresIntroduction 171Artifacts in Imaging 172Accuracy of Intraoperative Ultrasound 173Scanning Procedure and Equipment 173Appearance of Tumor on Ultrasound 175Ultrasound Guided Procedures 177Conclusion 177References 17719 Brain Biopsy Techniques 179John Rossmeisl and Annie ChenIntroduction 179Indications and Contraindications 179Frame-based Stereotactic Brain Biopsy (SBBfb) 179SBBfb Technique 181Preoperative Evaluation 181Headframe Placement and Acquisition of Stereotactic Images 181SBBfb Planning 181SBBfb Procedure 183Postoperative Care and Adverse Events 184Processing of Brain Biopsy Specimens 184Frameless Stereotactic Brain Biopsy (SBBfl) 185SBBfl Technique 185Attachment of the Fiducial Markers 185Acquisition of Magnetic Resonance Images 186Registration Procedure 186Trajectory Planning 187Brain Biopsy 187Biopsy Sample Processing 187Conclusion 187References 18820 Surgical Management of Sellar Masses 190Tina Owen, Annie Chen-Allen and Linda MartinIntroduction 190Case Selection 191Preoperative Work up 192Neurologic Exam 192Preoperative Testing and Diagnostics 193Endocrine Testing 193Brain Imaging 193Imaging of Pituitary Masses 194Imaging of Non-Pituitary Sellar Masses 195Surgery 196Anatomy 196Localization 196Positioning 197Approach 197Surgical Outcome 198In Hospital Care 200Postoperative Management and Monitoring 200Postoperative Complications 200Endocrine and Metabolic Complications 200Respiratory Complications 203Neurologic Complications 204Procedural Related Complications 204Long term Follow Up 205References 20621 Surgical Management and Intraoperative Strategies for Tumors of the Skull 211Jonathan F. McAnultyOsteosarcoma and Multilobular Osteochrondrosarcoma of the Cranium 211Diagnosis and Characterization 212Surgical Planning and Treatment 212Exposure 212Challenges in Skull Tumor Resection 214Parietal Calvarial and Dorsal Frontal Bone Lesions 214Frontal Bone within the Orbit and Sphenoid Bone Lesions 215Occipital Bone Lesions 215MRI Assessment of Blood Flow to the Transverse Sinuses 216Slow Occlusion of Flow from the DSS to the Transverse Sinus Using a Balloon Catheter 217Extension of Tumor to the tentorium Cerebelli 218Zygomatic Arch and Ramus of the Mandible 218Complications and Risks 219Cranioplasty 220References 22122 Surgical Management of Intracranial Meningiomas 223R. Timothy BentleyIntroduction 223Anatomy 223Transfrontal Craniotomy (Bilateral Transfrontal Craniotomy) 225Technique 225Closure 227Modifications 228The Falx Cerebri and the Dorsal Sagittal Sinus (DSS) 229Rostrotentorial Craniectomy/Craniotomy (Lateral Craniectomy/Craniotomy) 231Technique 232Closure: Craniectomy vs Craniotomy 233Combined Rostrotentorial-Transfrontal Approach 234Suboccipital Craniectomy (See Also Chapter 24 Surgery of Caudal Fossa Tumors) 235Technique 235Closure 236Meningioma Resection and Instrumentation 236Simpson Classification of Meningioma Resection in Humans (Table 22.2) 237Substitutes for Resected Dura Mater 237Complications and Mitigation Strategies 239References 23923 Lateral Ventricular Fenestration 241Andy ShoresIntroduction 241Rationale 241Technique 242Potential Complications 243Discussion 243References 24824 Surgery of the Caudal Fossa 249Beverly K. SturgesAnatomy 249Indications for Surgery 250Preoperative Assessment and Anesthetic Management 251Surgical Positioning 251Surgical Approach(es) to the Caudal Fossa 252Midline Occipital Approach [3-5] 252Extended Lateral Approach with Occlusion of The Transverse Sinus [3, 6] 255Lateral Approach to The Cerebellum in Cats [8] 258Closing and Reconstruction 258Postoperative Care 259Complications 260References 26125 Transzygomatic Approach to Ventrolateral Craniotomy/Craniectomy 262Martin Young and Sandy ChenIntroduction 262Patient Positioning/Preparation 262Surgical Procedure 263References 266Index 269

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EditorsAndy Shores is a Clinical Professor of Neurosurgery and Neurology in the Mississippi State University College of Veterinary Medicine at The Veterinary Specialty Center in Mississippi, USA.Brigitte A. Brisson is Professor of Small Animal Surgery in the Department of Clinical Studies at the Ontario Veterinary College at the University of Guelph in Ontario, Canada.