Cervical ventral surgical approach to the brachial plexus for resection of an extraskeletal osteosarcoma in a dog

The aim of this report is to describe a new surgical approach to the brachial plexus for resection of an extraskeletal osteosarcoma in a dog. A ventral midline cervical skin incision and blunt dissection of the cervical soft tissue were performed to expose the sternohyoid and sternocephalicus muscles. The trachea, esophagus and recurrent laryngeal nerve were exposed and laterally retracted. A blunt dissection was performed between the external jugular vein and the carotid sheath caudally to the left axillae at the levels of C6, C7, and T1 to expose the mass. Dissection was performed around the mass. The abnormal spinal nerves were transected just ventral to the vertebral body, allowing complete mass removal. The dog was bright and comfortable following surgery. Two weeks later, adjuvant chemotherapy was performed with carboplatin and piroxicam. The dog had a nine-month overall survival from diagnosis to death. The ventral cervical surgical approach to the canine brachial plexus, as described in this report, demonstrated feasibility, and provided satisfactory visualization and access with minimal muscle disruption. This surgical approach may be considered for cases involving neoplasia of the brachial plexus.