Transiliac approach for exposure of lumbosacral intervertebral disk and foramen: technique description

Objective— To describe and evaluate a transiliac approach to the L7–S1 disk and intervertebral foramen in dogs.
Study Design— Cadaver study.
Animals— Fresh canine cadavers (n=10).
Methods— A craniolateral approach was made to each iliac wing of 10 fresh canine mixed breed cadavers. An 18 mm hole was drilled in a standardized position through the iliac wing. The musculature connected to the cranial aspects of the sacral wing was dissected and retracted cranially through this iliac window. Endoscopic exploration of the area was performed.
Results— The foramen and intervertebral disk were clearly observed in all specimens without iatrogenic injury of the L7 nerve branch. Access to the foramen was possible in 16 of 20 specimens without excision of the sacral wing; however, it was always partially excised to observe the intervertebral disk which lies more caudally and ventrally.
Conclusion— Transiliac approach to the lumbosacral joint allows direct exposure of the intervertebral disk and foramen through an iliac window. Endoscopic exploration provided good observation of the intervertebral disk and/or foramen.
Clinical Relevance— Transiliac approach could be used for lateral corpectomy and foraminotomy in dogs with degenerative lumbosacral stenosis caused by ventral or ventrolateral disk protrusion, foramen stenosis, or OCD of the L7–S1 joint. Clinical study will be necessary to evaluate the efficacy of this approach.