Hemilaminectomy is a surgical procedure used to access the spinal canal, creating a small opening in the spine. It is commonly used to treat slipped or herniated discs in the thoracolumbar spine of dogs, which is the upper to middle part of the back. A mini-hemilaminectomy is a common variation of this procedure. 

In cases of Intervertebral Disc Extrusion (IVDE), the aim is to remove the disc material that has entered the spinal space. This removes the pressure on the spinal cord, preventing further damage and allowing it to heal. 

What is a hemilaminectomy or mini-hemilaminectomy?

In dogs, the spinal cord runs within a canal in the spinal column. If they develop IVDE, disc material escapes into this space and presses on the spinal cord. To remove this material without causing further damage, an opening must be created in the bones of the spine (vertebrae).

• A mini-hemilaminectomy creates a very small opening, without affecting the overall structure of the bone. This is ideal when only a small amount of disc material needs to be removed, and when the material is all in one area.

• A hemilaminectomy creates a larger opening, allowing for further examination of the spinal cord and removal of disc material over a wider area, if needed. However, this procedure can make this part of the spine slightly more fragile.

How is a hemilaminectomy or mini-hemilaminectomy performed in dogs?

• Your dog will receive pain medication and general anaesthesia. Other medications may also be administered if there are concerns about preventing specific complications.

• They will be placed on their tummy during the procedure. A skin opening (incision) will be made on their back, over the affected area of the spine. The muscles and other structures will be gently moved to the side so the surgeon can reach the bones of the spine.

• Specialised equipment will then be used to create a small opening in the bone, allowing the surgeon to remove all of the disc material present in the spinal canal. This allows the spinal cord and nerves to regain the space they need, giving them a chance to heal and recover.

• When safe and practical, a further procedure may be recommended, called disc fenestration. The intervertebral disc is opened to remove any remaining diseased material. It aims to prevent further episodes of disc material entering the spinal space. This procedure isn’t always possible or necessary.

How much does a hemilaminectomy or mini-hemilaminectomy cost in dogs?

• Hemilaminectomy and mini-hemilaminectomy are complex procedures requiring specialist training, skill, and specialised equipment.

• The cost of the procedure will vary between different veterinary hospitals.

• Pre- and post-operative care are complex and require specific medications and several days of hospitalisation. This can significantly increase costs and make them difficult to predict from the outset.

• Your vet will discuss the expected costs as part of the treatment plan and will keep you informed of any major changes.

What are the risks of a hemilaminectomy or mini-hemilaminectomy in dogs?

Both hemilaminectomy and mini-laminectomy have a very high success rate, and complications are very rare.

•  When complications happen, they are similar to most other surgical procedures, such as:

  • Excessive bleeding

  • Accidental damage to tissues

  • Infection at the operation site

• In very rare cases, the bone from which a small portion was removed may fracture or move into an abnormal position (subluxation).

Recovery tips after a hemilaminectomy or mini-hemilaminectomy in dogs

• Dogs will require hospital care for a few days to a couple of weeks after a hemilaminectomy or mini-hemilaminectomy.

• When they can go home, they will need strict crate rest for at least 4 weeks. During this period, movement outside the crate must be limited to toileting, 4 times a day, for a maximum of 5 minutes each time. They must be kept on a short lead and harness for this, or a sling if necessary. It’s essential to prevent climbing, jumping, playing and excessive time outside the crate. Severe complications may develop if this is not followed.

• You will receive specific instructions about wound care when picking up your dog. In most cases, no wound cleaning is needed, and often the stitches don’t need to be removed.

• There may be specific home instructions, depending on your dog's symptoms, such as bladder expression or using a urinary catheter. A sling should be used to help support the body if weakness or lack of coordination is present. Make sure to follow your vet’s instructions carefully, and ask questions if there’s anything you’re unsure about. 

• Dietary changes may be needed during the rest period to account for the reduction in physical activity. Usually, a 25% reduction in caloric (energy) intake is advisable, but the team at your practice can provide specific advice. 

• Mental stimulation and enrichment will help prevent anxiety and frustration during rest. Lick mats and puzzle toys are good ways to help with this. Your vet team can also provide further advice regarding this.

When to worry after a hemilaminectomy or mini-hemilaminectomy

Call the vet straight away if you notice:

• Worsening of symptoms like weakness, wobbliness or struggling to stand

• Significant pain

• Swelling, discharge or opening of the surgical wound

• No urine has been passed for more than 24 hours