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BackgroundReduced pelvic limb reflexes in dogs with spinal cord injury typically suggests a lesion of the L4‐S3 spinal cord segments. However, pelvic limb reflexes might also be reduced in dogs with a T3‐L3 myelopathy and concurrent spinal shock.Hypothesis/ObjectivesWe hypothesized that statistical models could be used to identify clinical variables associated with spinal shock in dogs with spinal cord injuries.AnimalsCohort of 59 dogs with T3‐L3 myelopathies and spinal shock and 13 dogs with L4‐S3 myelopathies.MethodsData used for this study were prospectively entered by partner institutions into the International Canine Spinal Cord Injury observational registry between October 2016 and July 2019. Univariable logistic regression analyses were performed to assess the association between independent variables and the presence of spinal shock. Independent variables were selected for inclusion in a multivariable logistic regression model if they had a significant effect (P ≤ .1) on the odds of spinal shock in univariable logistic regression.ResultsThe final multivariable model included the natural log of weight (kg), the natural log of duration of clinical signs (hours), severity (paresis vs paraplegia), and pelvic limb tone (normal vs decreased/absent). The odds of spinal shock decreased with increasing weight (odds ratio [OR] = 0.28, P = .09; confidence interval [CI] 0.07‐1.2), increasing duration (OR = 0.44, P = .02; CI 0.21‐0.9), decreased pelvic limb tone (OR = 0.04, P = .003; CI 0.01‐0.36), and increased in the presence of paraplegia (OR = 7.87, P = .04; CI 1.1‐56.62).Conclusions and Clinical ImportanceA formula, as developed by the present study and after external validation, could be useful for assisting clinicians in determining the likelihood of spinal shock in various clinical scenarios and aid in diagnostic planning.  相似文献   

3.
The purpose of this study was to compare half-Fourier-acquisition single-shot turbo spin-echo (HASTE) and T2-weighted (T2-W) sequences in dogs with thoracolumbar disc extrusion. MRI studies in 60 dogs (767 individual intervertebral disc spaces) were evaluated. Agreement between T2-W and HASTE sequences was assessed for two criteria: presence of an extradural lesion and treatment recommendation. There was moderate agreement between T2-W and HASTE sequences as to presence of an extradural lesion (kappa = 0.575). HASTE was in agreement in 96.1% of the sites where no extradural lesion was identified on T2-W images, but only in 58.1% of the sites where extradural lesions were identified on T2-W images. There was also moderate agreement between T2-W and HASTE sequences as to treatment recommendations (kappa = 0.476). HASTE was in agreement in 98.4% of the sites where a lesion was considered nonsurgical on T2 but only 82.1% of sites a lesion was considered surgical on T2. In 1.0% of sites considered not surgical and in 9.8% of sites considered equivocal based on T2-W images, a surgical lesion was identified on HASTE. Acquisition of a HASTE sequence in addition to conventional sequences may be beneficial in determining the severity of spinal cord compression in some cases when evaluating the canine spine.  相似文献   

4.
Forty‐six dogs with either cervical (C1–C5 or C6–T2) or thoracolumbar (T3–L3) acute myelopathy underwent prospective conventional computed tomography (CT), angiographic CT, myelography, and CT myelography. Findings were confirmed at either surgery or necropsy. Seventy‐eight percent of lesions were extradural, 11% were extradural with an intramedullary abnormality, 7% were intramedullary, 2% were intradural–extramedullary, and 2% had nerve root compression without spinal cord compression. Intervertebral disc herniation was the most frequent abnormality regardless of signalment or neurolocalization. Twenty‐one of 23 Hansen type I disc extrusions but none of the Hansen type II disc protrusions were mineralized. Two chondrodystrophic dogs had acute myelopathy attributable to extradural hemorrhage and subarachnoid cyst. CT myelography had the highest interobserver agreement, was the most sensitive technique for identification of compression, demonstrating lesions in 8% of dogs interpreted as normal from myelography and enabling localization and lateralization in 8% of lesions incompletely localized on myelography due to concurrent spinal cord swelling. None of the imaging techniques evaluated permitted definitive diagnosis of spinal cord infarction or meningomyelitis but myelography and CT myelography did rule out a surgical lesion in those cases. While conventional CT was adequate for the diagnosis and localization of mineralized Hansen type I disc extrusions in chondrodystrophic breeds, if no lesion was identified, plegia was present due to concurrent extradural compression and spinal cord swelling, or the dog was nonchondrodystrophic, CT myelography was often necessary for correct diagnosis.  相似文献   

5.
随着椎间盘退变中椎间盘组织再吸收现象越来越多被报道,作为其吸收机制中重要的因素之一,基质金属蛋白酶(MMPs)也越来越被人们所关注。论文介绍了退变椎间盘组织再吸收的现象,并对参与退变组织吸收过程的MMPs进行重点论述,通过MMPs与其他作用因素间关系的揭示,为临床应用MMPs局部注射治疗腰椎间盘突出症提供更加丰富的理论参考。  相似文献   

6.
The case details and outcome after surgical decompression of 46 dogs with thoracolumbar intervertebral disc disease with loss of deep pain perception prior to surgery were reviewed. Nineteen dogs (41.3%) recovered with a median follow-up period of 12.5 months. Recovery was defined as an ambulatory paraparesis, or better, with urinary and fecal continence. There was a better outcome in dogs with loss of deep pain for less than 24 hours prior to surgery (19/41; 46.3% recovered) than in dogs without deep pain perception for more than 24 hours (0/5; 0% recovered). Dogs with deep pain perception present at two weeks postoperatively had significantly higher success rate (8/12; 66.7% recovered) than dogs without deep pain perception at this time period (1/10; 10.0% recovered). The return of deep pain perception by two weeks postoperatively can be a useful positive prognostic indicator.  相似文献   

7.
Progressive myelomalacia (PMM) is a fatal sequela of acute thoracolumbar intervertebral disc extrusion in dogs, with unpredictable onset in the days after the inciting injury. No single reliable diagnostic test is currently available. Magnetic resonance imaging (MRI) features such as T2-weighted spinal cord hyperintensity and loss of subarachnoid signal in a half-Fourier single-shot turbo spin echo (HASTE) sequence have been associated with PMM, but are sometimes present in other dogs with severe deficits. Magnetic resonance imaging findings in 22 dogs with a clinical or histopathologic diagnosis of PMM and 38 deep pain-negative paraplegic dogs were compared in a retrospective case-control study. Length of T2-weighted hyperintense spinal cord change and HASTE signal loss were significantly associated with clinically evident PMM (P = .0019 and P = .0085), however, there were no significant differences between groups when analysis was restricted to dogs not yet showing clinical signs of PMM. The PMM group also had significantly shorter compressive lesions than the control group (P = 0.026), suggesting a possible role of more severe focal pressure at the extrusion site. A segment of total loss of contrast enhancement in the venous sinuses and meninges, a feature not previously described, was more common in the PMM group and the difference approached significance (P = 0.054). Findings show that MRI features can support the diagnosis in dogs with clinical evidence of PMM, and absence of these features supports absence of PMM at time of imaging. However, their absence does not reliably differentiate dogs with imminent progressive myelomalacia from other dogs with severe deficits following intervertebral disc extrusion.  相似文献   

8.
Subarachnoid-pleural fistula is a rare occurrence in humans as a result of trauma or spinal surgery. Such fistulas commonly remain undiagnosed until sufficient cerebrospinal fluid accumulates in the pleural space to cause respiratory distress. We describe a subarachnoid-pleural fistula in a dog that occurred subsequent to blunt trauma sustained during a fall, with concurrent acute, traumatic intervertebral disc rupture. The extruded disc material penetrated the dura mater, allowing communication between the subarachnoid space and the extrapleural thoracic cavity. Radiographic, myelographic, and computed tomographic (CT) findings are reviewed. Abnormalities noted during myelography included an intradural-extramedullary lesion at T11-T12, with epidural leakage of contrast medium from the region of T12 extending cranially. In images from myelography and CT there was extravasation of contrast medium extending from the subarachnoid and epidural space into the extrapleural thoracic cavity.  相似文献   

9.
The increase in client willingness to pursue surgical procedures, the heightened perceived value of veterinary patients, and the desire to provide comprehensive medical care have driven the recent demand of using an integrative treatment approach in veterinary rehabilitation. Physical therapy following neurologic injury has been the standard of care in human medicine for decades, whereas similar rehabilitation techniques have only recently been adapted and utilized in veterinary medicine. Spinal cord injury is the most common neurologic disease currently addressed by veterinary rehabilitation specialists and will be the primary focus of this review; however, research in other neurologic conditions will also be discussed. Of particular interest, to clients and veterinarians are techniques and modalities used to promote functional recovery after neurologic injury, which can mean the difference between life and death for many veterinary patients.The trend in human neurologic rehabilitation, often regardless of etiology, is a multimodal approach to therapy. Evidence supports faster and improved recoveries in people after neurologic injury using a combination of rehabilitation techniques. Although the primary neurological disorders researched tend to be spinal cord injury, peripheral neuropathies, allodynia, multiple sclerosis, and strokes—many correlations can be made to common veterinary neurological disorders. Such comprehensive protocols entail gait training activities in combination with neuromuscular electrical stimulation and directed exercises. Additionally, pain-relieving and functional benefits are bolstered when acupuncture is used in addition to rehabilitation. Studies, both laboratory and clinical, support the use of acupuncture in the management of neurologic conditions in small animals, specifically in cases of intervertebral disc disease, other myelopathies, and neuropathic pain conditions. Acupuncture’s ability to promote analgesia, stimulate trophic factors, and decrease inflammation, including neuroinflammation, make it an alluring adjunct therapy after neurologic injury.Although there is limited research in veterinary medicine on physical techniques that expedite recovery after neurologic injury, there are sparse publications on clinical veterinary research suggesting the benefits of acupuncture, rehabilitation, and LASER in dogs with intervertebral disk disease. Accordingly, due to the relative lack of evidence-based studies in veterinary neurologic rehabilitation, much of the data available is human or laboratory-animal based, however, evidence supports the utilization of an early, comprehensive treatment protocol for optimal neurologic recovery. The rationale for why an integrative approach is critical will be detailed in this review; in addition, literature on specific physical rehabilitation techniques that have evidence of improved recoveries after neurologic injury, will be addressed.  相似文献   

10.
To assess the diagnostic accuracy of survey radiography for canine thoracolumbar intervertebral disc protrusion, survey radiographs (lateral and ventrodorsal) of 64 dogs with surgically-confirmed thoracolumbar intervertebral disc protrusion, 51 dogs with negative myelograms and 29 dogs with various spinal conditions other than disc protrusion were reviewed by three independent observers who were unaware of any clinical information. There were marked differences in observer performance for diagnosis of intervertebral disc protrusion, although there were no significant differences in intraobserver diagnostic accuracy for small vs. large dogs. Accuracy of observers for determining sites of intervertebral disc protrusion using survey radiography was in the range 51-61%. All observers had low accuracy for identification of second sites of intervertebral disc protrusion. The most useful radiographic sign, narrowed intervertebral space, had only moderate sensitivity (range 64-69%) and moderate predictive value (range 63-71%) for intervertebral disc protrusion. Vacuum phenomenon was an infrequent but accurate sign of intervertebral disc protrusion. Recognition of multiple radiographic signs of intervertebral disc protrusion at one site was associated with increased accuracy of diagnosis. No observer was accurate enough to justify attempting targeted surgical treatment of intervertebral disc protrusion without myelography.  相似文献   

11.
The caudal lumbar and lumbosacral spine of 13 dogs with pain or neurologic deficits were evaluated using magnetic resonance imaging (MRI). Spin echo T1, proton density, and T2 weighted and gradient echo T2* imaging sequences were utilized. MRI permitted direct, multiplanar, tomographic visualization of the spine facilitating evaluation of all components of degenerative caudal lumbar and lumbosacral stenosis. Abnormalities detected included intervertebral disc degeneration, intervertebral disc protrusion involving both the vertebral canal and intervertebral foramina, articular process osteophytosis, articular process fracture, nerve root impingement by spondylosis deformans, and the presence of low signal material within the vertebral canal of 2 dogs with recurrent pain following previous spinal surgery. In all 7 dogs treated surgically, MRI findings were consistent with surgical findings.  相似文献   

12.
Sagittal T2‐weighted sequences (T2‐SAG) are the foundation of spinal protocols when screening for the presence of intervertebral disc extrusion. We often utilize sagittal short‐tau inversion recovery sequences (STIR‐SAG) as an adjunctive screening series, and experience suggests that this combined approach provides superior detection rates. We hypothesized that STIR‐SAG would provide higher sensitivity than T2‐SAG in the identification and localization of intervertebral disc extrusion. We further hypothesized that the parallel evaluation of paired T2‐SAG and STIR‐SAG series would provide a higher sensitivity than could be achieved with either independent sagittal series when viewed in isolation. This retrospective diagnostic accuracy study blindly reviewed T2‐SAG and STIR‐SAG sequences from dogs (n = 110) with surgically confirmed intervertebral disc extrusion. A consensus between two radiologists found no significant difference in sensitivity between T2‐SAG and STIR‐SAG during the identification of intervertebral disc extrusion (T2‐SAG: 92.7%, STIR‐SAG: 94.5%, P = 0.752). Nevertheless, STIR‐SAG accurately identified intervertebral disc extrusion in 66.7% of cases where the evaluation of T2‐SAG in isolation had provided a false negative diagnosis. Additionally, one radiologist found that the parallel evaluation of paired T2‐SAG and STIR‐SAG series provided a significantly higher sensitivity than T2‐SAG in isolation, during the identification of intervertebral disc extrusion (T2‐SAG: 78.2%, paired T2‐SAG, and STIR‐SAG: 90.9%, P = 0.017). A similar nonsignificant trend was observed when the consensus of both radiologists was taken into consideration (T2‐SAG: 92.7%, paired T2‐SAG, and STIR‐SAG = 97.3%, P = 0.392). We therefore conclude that STIR‐SAG is capable of identifying intervertebral disc extrusion that is inconspicuous in T2‐SAG, and that STIR‐SAG should be considered a useful adjunctive sequence during preliminary sagittal screening for intervertebral disc extrusion in low‐field magnetic resonance.  相似文献   

13.
A minimally invasive method for delivering injectable therapeutic agents would be desirable for the treatment of intervertebral disc disease in dogs. The purpose of this study was to compare computed tomography (CT), ultrasonography (US), and fluoroscopy modalities for guiding percutaneous injection into canine intervertebral discs. Intervertebral discs of 14 dog cadavers were injected with a gelified ethanol therapeutic agent. Successful injectate placement and injectate leakage were determined based on necropsy inspection of discs. Injection into the nucleus pulposus was successful in 55 of 78 (71%) of all injected discs. Injections guided using CT and fluoroscopy were significantly more successful than US‐guided injections. Odds of successful injection without leakage were greater for CT vs. US (P = 0.0026) but there was no significant difference between CT and fluoroscopy (P = 0.0620). Injection success rates did not differ among vertebral sites or dog cadavers of varying weights. Forty‐nine (63%) of injection sites had injectate leakage outside the disc and 10 of these involved structures within the vertebral canal. The highest rate of injection success with the least amount of leakage was achieved with CT guidance. Findings indicated that CT, fluoroscopy, and US are feasible modalities for guiding percutaneous injection of a gelified ethanol therapeutic agent into the canine intervertebral disc, with moderate to high success rates for different regions of the spine. However, a moderately high rate of injectate leakage occurred outside of the disc and this should be taken into consideration for future safety and efficacy studies.  相似文献   

14.
为了探索治疗犬腰椎间盘突出症的合理手术入路,选择2月龄～1岁龄临床健康的本地杂交犬5只,分别编为1号～5号犬,其中1号、2号、3号犬施行半侧椎板切除术,4号、5号犬施行全椎板切除术,手术2周后进行X线摄片并剖检其腰椎结构变化。结果显示,术后1号～3号犬精神状态良好,饮食欲及体温正常,术部切口正常愈合,椎间盘部分或全部髓核被顺利取出;4号、5号犬手术中大出血,经治疗4号犬痊愈,而5号犬因衰弱而死亡。结果表明,腰椎间盘切除术要求严格的无菌操作和有效控制的麻醉,术犬侧卧位保定行半侧椎板切除是良好的手术入路,能够充分显露椎间盘、打开纤维环通道和切除髓核,有利于提高手术的安全性和保持腰椎的完整性与稳定性。  相似文献   

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16.
Cervical spinal disorders can lead to life‐threatening respiratory complications. Diaphragmatic dysfunction is attributed to spinal cord morbidity secondary to cervical myelopathy or decompressive surgical intervention. The purpose of this observational case‐control study was to determine the frequency of diaphragmatic dysfunction in dogs with cervical spinal disorders and a control group, the strength of association between cervical myelopathies and decompressive surgery with diaphragm paresis, and the agreement between and clinical usefulness of fluoroscopy, motion‐mode ultrasonography, and radiography for diagnosing diaphragmatic dysfunction. Thirty‐five client‐owned dogs were recruited with 14 control dogs and 21 test dogs. Dogs were evaluated for the presence of diaphragmatic dysfunction using radiography, M‐mode ultrasonography, and fluoroscopy before and after an anesthetic or surgical event. Diaphragmatic dysfunction was observed more frequently in dogs with cervical spinal disease prior to surgery (8/21; 38.1%) compared to control dogs (3/14; 21.4%) but was not statistically significant (P = .30). The occurrence of diaphragmatic dysfunction did not significantly increase following surgical decompression in either group. There was no to slight agreement between all imaging modalities. Most dogs with diaphragmatic dysfunction were asymptomatic. Diaphragmatic dysfunction was not statistically associated with cervical myelopathy or decompressive surgery. Ultrasonography and radiography were not useful diagnostic tests for determining diaphragmatic dysfunction in asymptomatic dogs when compared to fluoroscopy.  相似文献   

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18.
Myelography and/or computed tomography (CT) are commonly used to evaluate acute intervertebral disk extrusion in chondrodystrophic dogs. The purpose of this study was to evaluate the sensitivity of myelography and two different CT protocols in determining level and lateralization of acute thoracolumbar intervertebral disk extrusion in comparison with surgical findings, investigate interobserver variability, and determine examination duration times. Results of conventional CT, helical CT, and myelography were compared with surgical findings in 19 chondrodystrophic dogs with acute thoracolumbar intervertebral disk extrusion. Agreement among investigators was determined for different imaging modalities, and examination times were recorded. In the diagnosis of level of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 94.7%, 100%, and 94.7% of dogs, respectively ( P =0.144). In the diagnosis of level and lateralization of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 78.9%, 87.4%, and 85.3% of dogs, respectively ( P =0.328). Interobserver agreement was very good for all imaging modalities (myelography κ=0.87; conventional CT κ=0.86; helical CT κ=0.95). There were significant differences in median examination duration times between helical CT (4 min), conventional CT (8 min), and myelography (32 min) ( P <0.001). Both helical and conventional CT appear to be accurate for evaluation of acute thoracolumbar intervertebral disk extrusion in chondrodystrophic dogs and are faster to perform than myelography.  相似文献   

19.
Hind limb paresis or plegia in ferrets is a common sign of illness, which can be produced by intervertebral disc (IVD) extrusion or protrusion along with many other systemic diseases. This case report describes a ferret (Mustela putorius furo) with chronic onset paraplegia in which T7-T8, T8-T9, and T10-T11 IVD herniations and T9-T10 block vertebrae were diagnosed with the assistance of myelography. It is believed that the excessive stress on the adjacent annulus fibrosus and vertebral endplates resulting from block vertebrae could have been the cause of IVD disease in the atypical location described in this case.  相似文献   

20.
The diagnosis of discospondylitis is based on radiographic changes in the vertebrae. The limitations of this method are the time gap between the onset of clinical signs and the first appearance of the radiographic findings, as well as the disassociation between the clinical and radiographic signs during recovery. It is known that the radiographic changes appear only two to four weeks after the onset of clinical signs, but the characteristics of radiographic changes during recovery has yet to be documented, thus making follow-up radiographs difficult to interpret. A prospective and retrospective study was designed to document typical radiographic changes during recovery from discospondylitis. We reviewed 12 dogs that had complete and uneventful recovery with antibiotic therapy alone. Periodic follow-up radiographs and clinical examinations were conducted up to five months after the onset of clinical signs to correlate between the clinical status and radiographic changes during recovery. Although the clinical signs improved within the first 10 days of antibiotic therapy, the radiographic deterioration continued before regression and signs of radiographic recovery were noticed. This radiographic deterioration, despite successful antibiotic therapy, appeared shorter in young dogs (less than one year old) and lasted three to nine weeks in older dogs.  相似文献   

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