Biportal endoscopic foraminotomy of the L7-S1 neuroforamen in dogs: Description of surgical technique and ex vivo comparison with conventional open dorsolateral foraminotomy.

BEF-A offers superior visualization and foraminal enlargement for canine lumbosacral stenosis treatment.

This study introduces biportal endoscopic foraminotomy (BEF) as a minimally invasive alternative to conventional open dorsolateral foraminotomy for treating lumbosacral foraminal stenosis in dogs. Researchers developed and refined the BEF technique using a 3.0 mm 30° arthroscope (BEF-A) or 1.9 mm 0° needle arthroscope (BEF-N) across 18 cadaveric specimens. Bilateral L7-S1 foraminotomy was performed in 24 neuroforamina comparing three surgical approaches. BEF-A demonstrated superior visualization compared to both conventional dorsolateral foraminotomy and BEF-N. All techniques safely enlarged the neuroforamen significantly, with BEF-A achieving 81.3% enlargement versus 59.7% for open surgery and 51.1% for BEF-N. No iatrogenic nerve root damage occurred in any procedure. Clinical application was demonstrated in one client-owned dog with lumbosacral foraminal stenosis treated successfully via BEF-A. The authors conclude BEF-A represents a safe, effective, minimally invasive surgical technique with superior visualization and efficacy compared to traditional open approaches, warranting further evaluation through larger clinical studies.

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