What question did this study set out to answer?

To establish a minimally invasive surgical technique for foraminotomy and compare it with conventional methods in dogs.

March 14, 2026Open Access

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

Key Points

To establish a minimally invasive surgical technique for foraminotomy and compare it with conventional methods in dogs.
Developed a biportal endoscopic foraminotomy technique using two types of arthroscopes in cadaveric spines.
Performed bilateral foraminotomy on 18 spinal specimens, comparing biportal endoscopic and dorsolateral approaches.
Evaluated visualization, nerve root damage, and foraminal enlargement among the three surgical techniques.
BEF-A offered better visualization than DF and BEF-N, showing statistical significance (p < .05).
No nerve root damage was detected in any surgical approach.
All procedures led to significant foraminal enlargement, averaging 58 ± 33% (p < .01), with BEF-A achieving the most enlargement (81.3 ± 30.0%) compared to DF and BEF-N.

Abstract

Abstract Objective (1) To establish a surgical technique for minimally invasive biportal endoscopic foraminotomy (BEF) of L7–S1 in dogs using arthroscopic equipment. (2) To compare BEF and dorsolateral foraminotomy (DF) and (3) to provide clinical results of the first client‐owned dog treated by way of BEF. Study design Ex vivo cadaveric study, case report. Sample population A total of 18 cadaveric lumbosacral spinal specimens (L3–S3). A 4‐year‐old mixed breed dog with lumbosacral foraminal stenosis. Methods A surgical technique using a 3.0 mm 30° arthroscope (BEF‐A) or a 1.9 mm 0° needle arthroscope (BEF‐N) was developed in six cadaveric spines. Bilateral L7–S1 foraminotomy was performed in 12 spinal specimens (24 neuroforamina) by (1) DF, (2) BEF‐A or (3) BEF‐N ( n = 8/group). Visualization, iatrogenic nerve root damage, and foraminal enlargement were compared between the three procedures. Results BEF‐A provided superior visualization compared to DF and BEF‐N ( p < .05). Iatrogenic nerve root damage was not observed in any of the procedures. All procedures resulted in significant enlargement of the neuroforamen (58 ± 33%, p < .01). BEF‐A (81.3 ± 30.0%) resulted in significantly more enlargement compared to DF (59.7 ± 33.7%, p = .03) and BEF‐N (51.1 ± 38.8%, p = .04). BEF‐A was successfully used to treat a client‐owned dog with L7–S1 foraminal stenosis. Conclusion BEF‐A provided superior visualization and efficacy compared to DF. Clinical significance BEF‐A is a safe and effective surgical technique for treating dogs with L7–S1 foraminal stenosis. The technique should be evaluated in larger clinical studies.

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