Don't have time to post all of my notes, but after hearing Dr. Dewey's description of the titanium mesh with screws and then hearing Dr. Shores describe the swine (intestinal submucosa) duraplasty with adipose fat pad graph (taken from the Cavalier's hip/butt area) on top, I would be more favorably inclined to have surgery done at Auburn. (Of course I also live 2 hrs away.) Dr. Shores also does a dorsal laminectomy at C1, which I presume is unique to Auburn, and that would seem to have additional decompression effects. Post-op in-hospital recovery is only about two days.
Auburn has had 23 patients over three years, and they have follow-up stats with 21 patients (longest follow-up is 31 months). Most have been Cavaliers and Chihuahuas. Most have done well, with about half of them on no meds after surgery. One of the patients has not done well and may require a second surgery, but this dog has complications with PSOM and extreme atopy (food allergies). These factors can continue to drive hypersensitivity issues. Auburn does a pre-screening dermatology consult. I've got more notes to post but no time.
LIVS has done about 100 FMD surgeries per Dr. Dewey's speaker notes, so there would be more follow-up stats with those dogs. More on that later. I don't know if they are still using titanium mesh on the west coast or the number of post-surgical patients or length of follow-up and related stats.
Dr. Dewey commented that new thinking is that there is more global compression of the brain and so perhaps there should be additional decompression done at the top of the skull to obtain better post-surgical results. That was an extremely sobering thought to me.
There is a team of residents at Auburn who are all learning the swine duraplasty technique, so it would seem that the Auburn approach will spread to other hospitals.
Caveat: My expressed opinion is not based on indepth study, which of course I would do if I had a dog with SM for which I was considering surgery. With indepth study, my opinion may be different.
I should add for those not following other threads that these two speakers presented at the AVMA convention in Atlanta on July31/Aug1 which I attended. Also, I reported earlier that there were about 15 attendees at Dr. Dewey's session; there were 17 attendees at Dr. Shores' session. Dr. Shores' first comment was how disappointed he was at the number of attendees. (In contrast, at some of the sessions on liver, pancreatitis, etc., there were probably 300-400 attendees.)
Pat