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Gomes et al: Post‐surgical outcome and recurrence rates in thoracolumbar arachnoid diverticula undergoing durotomy alone or alongside a modified technique of subdural shunt-placement in dogs
Veterinary Surgery 5, 2025

🔍 Key Findings

  • Modified subdural shunt (SDS) placement was adapted from prior techniques using a hemilaminectomy approach and no suturing of the dura or shunt.
  • Dogs receiving SDS had significantly better long-term outcomes (85.7% improved) compared to those with durotomy alone (41.7%).
  • Recurrence rate was lower in the SDS group (14.3%) than control (41.7%), though not statistically significant.
  • Most recurrences occurred in Pugs (5/7), suggesting a breed predisposition.
  • Shunt size was limited to 25% of spinal cord diameter, typically 3–3.5 Fr.
  • CSF flow through the shunt was confirmed intraoperatively, supporting the role of SDS in maintaining flow and possibly preventing recurrence.
  • Immediate postoperative outcomes were not different between groups (≈42% deteriorated), but long-term recovery was better with SDS.
  • Steroid use pre-surgery did not correlate with improved outcome; fewer SDS dogs received steroids pre-op.

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← Articles

Gomes et al: Post‐surgical outcome and recurrence rates in thoracolumbar arachnoid diverticula undergoing durotomy alone or alongside a modified technique of subdural shunt-placement in dogs
Veterinary Surgery 5, 2025

🔍 Key Findings

  • Modified subdural shunt (SDS) placement was adapted from prior techniques using a hemilaminectomy approach and no suturing of the dura or shunt.
  • Dogs receiving SDS had significantly better long-term outcomes (85.7% improved) compared to those with durotomy alone (41.7%).
  • Recurrence rate was lower in the SDS group (14.3%) than control (41.7%), though not statistically significant.
  • Most recurrences occurred in Pugs (5/7), suggesting a breed predisposition.
  • Shunt size was limited to 25% of spinal cord diameter, typically 3–3.5 Fr.
  • CSF flow through the shunt was confirmed intraoperatively, supporting the role of SDS in maintaining flow and possibly preventing recurrence.
  • Immediate postoperative outcomes were not different between groups (≈42% deteriorated), but long-term recovery was better with SDS.
  • Steroid use pre-surgery did not correlate with improved outcome; fewer SDS dogs received steroids pre-op.

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Multiple Choice Questions on this study

In Gomes 2025 et al., on subdural shunting for TL-AD, what was the significant long-term outcome of SDS placement compared to durotomy alone?

A. Higher immediate deterioration rate
B. Significantly worse neurological outcomes
C. No difference in long-term recovery
D. Significantly improved long-term neurological recovery
E. Lower perioperative infection rates

Answer: Significantly improved long-term neurological recovery

Explanation: 85.7% of dogs with SDS improved long-term vs. 41.7% with durotomy alone (p = 0.04).
In Gomes 2025 et al., on subdural shunting for TL-AD, which modification was part of the surgical technique for SDS placement?

A. Use of dorsal laminectomy and I-shaped dural incision
B. Hemilaminectomy with longitudinal durotomy and no suturing of shunt or dura
C. Use of titanium shunt sutured to dura
D. Use of extradural shunt with I-shaped durotomy
E. Shunt placement with dural closure using 4-0 Prolene

Answer: Hemilaminectomy with longitudinal durotomy and no suturing of shunt or dura

Explanation: The modified technique used a hemilaminectomy, longitudinal dural incision, and avoided suturing either the dura or the shunt tube.
In Gomes 2025 et al., on subdural shunting for TL-AD, what was the guideline for selecting shunt tube size?

A. Based on vertebral canal width
B. Always 3 Fr in all dogs
C. Based on 25% of spinal cord diameter at the lesion site
D. Based on bodyweight and breed
E. Selected randomly by the surgeon

Answer: Based on 25% of spinal cord diameter at the lesion site

Explanation: This ensured the tube did not compress the spinal cord; most dogs used 3–3.5 Fr tubing.
In Gomes 2025 et al., on subdural shunting for TL-AD, which breed was overrepresented among cases that recurred?

A. Pomeranian
B. Labrador Retriever
C. Pug
D. Cocker Spaniel
E. Miniature Schnauzer

Answer: Pug

Explanation: 5 of 7 recurrence cases were Pugs, consistent with prior literature showing breed predisposition.
In Gomes 2025 et al., on subdural shunting for TL-AD, which statement best reflects the recurrence findings?

A. Recurrence occurred only in French Bulldogs
B. All recurrences were seen within 6 months post-op
C. SDS placement significantly reduced recurrence (p < .05)
D. Recurrence rate was lower with SDS but not statistically significant
E. Recurrence was more common in dogs without durotomy

Answer: Recurrence rate was lower with SDS but not statistically significant

Explanation: SDS dogs had 14.3% recurrence vs. 41.7% in controls; p = .19.

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