Stereotactic Surgery

State-of-the-Art Technology Stereotactic Surgery Advances the Care of Pets with Brain Disease

Dr. Taylor
Dr. Amanda Taylor

The Neurology/Neurosurgery Service is offering advanced Stereotactic Surgery for patients, one of only a handful of veterinary medicine teaching hospitals able to offer this highly-specialized procedure. Referring veterinarians or owners should contact Dr. Amanda Taylor, assistant professor and clinician of Neurology/Neurosurgery, at art0022@auburn.edu, with a possible case or a pet in need of our care.

https://youtu.be/vo6oI9hZX6c

Background

When an owner is faced with a pet with brain disease, it can often be confusing and stressful. Owners may first see a difference in behavior or daily routine. Once they make the decision to move forward in finding out why their loved one is different, owners are often referred to a veterinary neurologist. In the past, diseases of the brain have been diagnosed in pets by looking at all available information: changes in their behavior or health, cerebrospinal fluid samples (spinal taps), and computed tomography (CT) or magnetic resonance (MR) images. Even when the answer is clear, such as the diagnosis of some brain tumors, veterinarians cannot always know how quickly the pet’s tumor will grow or make them sick. After an owner is given a diagnosis of brain cancer for their pet, they may have to make choices that are difficult, due to the possible terminal nature of the disease and the cost of treatment. One new option that can help veterinarians and owners decide the best course of action is the availability of minimally-invasive biopsies or surgery with stereotactic techniques.

Dog Brain
Dog with a brain tumor at the front portion of the brain. The image at the left depicts the dog’s MRI and the site identified for biopsy. The image at the right shows a 3D reconstruction of the brain tumor and the dog’s skin.

What is Stereotactic Surgery?

In human medicine, doctors rely on computer-assisted guidance, using stereotactic techniques, to perform safe biopsies of the brain. This allows the neurosurgeon to more carefully approach and potentially remove the brain tumor. This technology is now available at Auburn University Bailey Small Animal Teaching Hospital through our Neurology/Neurosurgery Service. We are excited to have the availability of this cutting-edge technology for our clients and referring veterinarians for their pets and patients.

implant recon
The image to the left is of a vertebrae with a path identified for implantation of a screw to stabilize the bones of the dog’s back. The image to the right is the corresponding CT of the dog after implantation of the implant in the vertebrae.

How Do We Use Stereotactic Surgery?

When a patient with disease in an area that is safer to biopsy with computer guidance (the brain, the spine, the tissue behind the eye, and in some cases the nose, etc.), Auburn veterinary clinicians can perform an MRI or a CT to collect images of the tumor mass. These images are transferred into computer system software, Brainsight®, which transforms the images to create a three-dimensional picture of the patient and the tumor mass that the surgeon uses as a guide to safely biopsy and potentially remove the disease.

This technology can be used to guide the entire surgery, down to millimeters of accuracy. The images allow us to plan the angle, depth and complexity of our surgery. During biopsy procedures, the operating veterinarian can visualize tools on images as they are inserted into tissue. Brainsight® helps the surgeon distinguish tumor from normal tissue, preventing damage to the healthy portion of the brain or nose, for instance.

lesion localization recon
The image to the left is a 3D reconstruction of a dog with a tumor behind her left eye. The corresponding images in the center and to the right are the dog’s MRI images with a target identified for biopsy.

Image-guided Stereotactic Surgery at Auburn University

When a patient is referred that may need the stereotactic unit to diagnose the cause, the Neurology/Neurosurgery Service works with the patient, owner (client), other specialties in the hospital, and referring veterinarians to determine what is best for each case.

Currently, the service has funds set aside for financial assistance for clients that consent to this new technique, when applicable. Some financial support is available for cases at the discretion of the hospital administration and Dr. Taylor.

For more information, contact Dr. Taylor at art0022@auburn.edu.

Dog Skin
The left image is a reconstruction of a dog’s skin and the bones of his back, the vertebrae. The right image is a reconstruction of the vertebrae (depicted in aqua) the spinal cord (in white) and a tumor which was destroying the bone (depicted in pink).