Fitzpatrick Referrals
Orthopaedics + Neurosurgery

Lumbosacral Disease

How is LS disease treated?

Various methodologies are available to treat lumbo-sacral disease depending on the cause and severity of the problem as well as the site of the nerve compression. We will advise you regarding the most suitable treatment for you dog on an individual basis.

1.Non-surgical management

Non-surgical management may allow some improvements in lameness or pain in the short term, particularly in patients with only very limited disease development. With consistent application of therapy, sustained improvement may be perceived for selected cases. We prefer to adopt a non-invasive approach if possible for LS disease and encourage most patients to try some of the following modalities which may be efficacious, before we would consider surgery. We have a fully equipped rehabilitation and hydrotherapy centre with two fully-qualified physical therapists. However, some patients are so badly affected that surgery may be an early choice to resolve significant clinical signs.

• Body-weight management.
• Exercise modification.
• Anti-inflammatory / pain relief medications – either supplied for oral administration or injected into the affected area.
• Physical therapy, manipulative therapies, laser therapy, ultrasound therapy.
• Shockwave therapy – we are the first practice in the UK to offer a small animal dedicated shock-wave treatment service. The technique is used widely in human and equine patients and has been shown to produce significant benefit in many cases of recalcitrant back pain and other conditions.
• Hydrotherapy – either in a pool or using an underwater treadmill.

2.Decompressive surgery (laminectomy)

For dogs affected only by extrusion or protrusion of the intervertebral disc with no evidence of instability or compression of the nerve roots, surgical decompression such as by dorsal laminectomy may be appropriate. This involves removal of some of the bony casing of the spinal canal, allowing us to remove any bulging or ruptured intervertebral disc material that might be compressing the cauda equina.

3.Lumbo-sacral distraction - fusion

Over recent years, we have developed an innovative operation for treatment of patients with lumbo-sacral disease where compression of the nerve roots supplying the back legs is present, and particularly where instability between the vertebrae is suspected. This technique involves distraction (stretching) of the lumbo-sacral joint by placing a specially-designed titanium bolt between the vertebrae, and providing additional stability using both pins and bone cement. This combined treatment immediately relieves the compression on the nerves, and allows the lumbo-sacral joint to fuse preventing further long-term problems from developing. We are currently the only veterinary centre worldwide routinely offering this technology.

Most patients are able to walk by the day after surgery, and are more comfortable than before the surgery within a few days. However, if the nerves have been severely damaged or compressed for a long period of time, some dogs can take several months to achieve their best possible outcome. Postoperative care is particularly important to avoid complications and to allow full rehabilitation after surgery, and our on-site physiotherapy and hydrotherapy teams are frequently involved with post-operative management of patients undergoing this type of treatment.