Peer-reviewed veterinary case report
Cost and benefits of preventive spinal surgery in short-legged dogs
By Low, Daniel et al.·Published in Journal of veterinary internal medicine·2025·frank. Pet Surgeons., United Kingdom·View original on PubMed →
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Original publication title: Longitudinal Assessment and Cost-Benefit Analysis of Prophylactic Fenestration in Chondrodystrophic Dogs With Follow-Up Magnetic Resonance Imaging.
- Species:
- dog
Plain-English summary
A group of 80 dogs with a breed known for back problems (chondrodystrophic dogs) who had previously suffered from intervertebral disc extrusion (a painful back condition) underwent a procedure called prophylactic fenestration to see if it would prevent future issues. After follow-up MRIs, the results showed that the procedure did not significantly reduce the chances of further disc problems compared to dogs that did not have the surgery. The study found that the health of the discs was more closely related to their condition before surgery than to whether they had the fenestration procedure. Overall, the procedure was not cost-effective for all dogs, but it might be beneficial for those at high risk.
People also search for: dog back problems treatment · intervertebral disc extrusion prevention · chondrodystrophic dog surgery cost · prophylactic fenestration for dogs
Abstract
BACKGROUND: Prophylactic fenestration (PF) has been reported to protect against recurrent intervertebral disc extrusion (IVDE), but recurrence is not always confirmed. No published studies address the cost-benefit of PF. OBJECTIVES: Observe the association between PF and intervertebral disc (IVD) survival and conduct cost-benefit analysis. ANIMALS: Eighty chondrodystrophic dogs with recurrent IVDE. METHODS: Longitudinal assessment with follow-up magnetic resonance imaging (MRI) was performed to retrospectively observe the survival of in situ IVDs. The association between PF and IVD survival was analyzed using a multivariable survival model, which included Pfirrmann grade as a covariate. Worst-case, base-case, and best-case cost-benefit simulations were conducted, corresponding to the lower 95% confidence interval (CI), point estimate, and upper 95% CI of the effect size of PF. RESULTS: For IVDs treated with PF, 4/31 (12.9%) IVDs were documented to subsequently extrude on follow-up MRI. For IVDs not treated with PF, 76/602 (12.6%) were documented to subsequently extrude on follow-up MRI. There was no association between the use of PF and IVD survival (time ratio: 1.17; 95% CI: 0.49-2.76; p = 0.72). An increase in Pfirrmann grade was associated with a decrease in IVD survival (time ratio: 0.34; 95% CI: 0.26-0.46; p < 0.001). Prophylactic fenestration was only cost-effective under a limited range of conditions. CONCLUSIONS AND CLINICAL IMPORTANCE: There was no evidence that PF prevented IVDE under study conditions. Pfirrmann grade was the strongest predictor of IVD survival. Universal use of PF was not cost-effective in multiple simulations. Targeted PF of high-risk IVDs may be considered the most cost-effective approach.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/40678823/