Today’s Diary Entry is sponsored by Eickemeyer
This morning I got to see a very cool surgery. Now the brain and nerves are still one of the big mysteries of medicine, so when we can help it is extremely rewarding. Today’s patient was a german sheperd that had no control over the bowl or bladder and so after the clinical exam it had been decided that surgery was in order.
You see there are different parts of the spinal cord within the spine – the cervical region (neck), thoracic (ribs), lumbar (lower back), sacral (where it joins the pelvis) and the cauda (the tail). Now the spinal cord itself usually ends just before the area where the lumbar spine connects to the sacrum (the iliosacrial junction). However the spinal cord has several nerve branches that arise from the end that are important for the pelvic region.
So there are two main types of problems with nerves, the first is that they are severed (cut), and the second that they are compressed so the signal cannot pass along. Severed nerves are a completely different story and worthy of their own diary entry so I will leave this for now. However looking at compression of nerves this can be from several causes including inflammation, bruising, tumours, or growths. Now the spine has a common problem called spondylosis which is where small bone bridges grow between different vertebra causing both pain and displacement of the disc that sits between them to act as a cushion. This disc is usually pushed upwards compressing the spinal cord and nerves against the back of the spinal canal.
Going back to today’s surgery the nerves leaving the end of spinal cord were being compressed so the surgery being performed was a spinal decompression via a dorsal laminectomy. Now this basically means removing the back part of the spinal canal (the dorsal lamina) so that the nerves have nothing to be squashed against. During the surgery I assisted on the anaesthesia (I belive its better to learn this properly early on as I can learn surgery anytime) so I only got to see parts however it was really cool being able to see the nerves within the spine.
It’s a pretty weird feeling seeing these little white snake like things that are responsible for the body working the way it does… This surgery is generally an advanced procedure and considered neurosurgery because of the level of skill and specialist equipment required to perform it so I got very lucky to be part of it even in a small way!