Influence of muscle-sparing lateral thoracotomy on postoperative pain and lameness – a randomized clinical trial

Anna E Nutt*, Toby G Knowles, Neil G Nutt, Jo C Murrell, Darren R Carwardine, Lee B Meakin, Guillaume P A Chanoit

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Objective: To assess and compare the magnitude of lameness and level of pain following muscle-sparing lateral thoracotomy (MSLT) and standard lateral thoracotomy (SLT) in dogs.
Study Design: Randomized, blinded prospective clinical study.Animals: 28 client-owned dogs.
Methods:The latissimus dorsi muscle was retracted in the MSLT group and was transected in the SLT group. Gait was analyzed with a force plate and the peak vertical force symmetry index (SI) was calculated within 24 hours before surgery, three days post-operatively, and 8-12 weeks post-operatively. SI and pain scores, measured by the Glasgow Composite Measure Pain Scale – Short Form, were assessed as primary outcome measures. 
Results: The SI three days post-operatively was lower than the pre-operative value in all dogs, consistent with lameness of the ipsilateral thoracic limb (P <0.001). The absolute differences in pre-operative and three days post-operative symmetry indices showed this change to be 3.1 times greater after SLT compared to MSLT (P = 0.009). Pain scores one day after surgery were lower after MSLT (1.0) compared to SLT (2.5, P < 0.001). 
Conclusion: Lateral thoracotomies caused post-operative pain and ipsilateral forelimb lameness, both reduced by sparing the latissimus dorsi. Clinical Significance: Sparing the latissimus dorsi should be considered to decrease immediate post-operative morbidity in dogs undergoing lateral thoracotomy.
Original languageEnglish
Pages (from-to)1227-1236
Number of pages10
JournalVeterinary Surgery
Issue number6
Early online date15 Feb 2021
Publication statusPublished - Aug 2021

Bibliographical note

Funding Information:
The authors thank Giorgia Brambilla BVSc MRCVS for assistance in the collection of data.

Publisher Copyright:
© 2021 The Authors. Veterinary Surgery published by Wiley Periodicals LLC. on behalf of American College of Veterinary Surgeons.


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