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1.
OBJECTIVE: To evaluate the postoperative morbidity and long-term outcome of dogs after dorsal laminectomy for caudal cervical spondylomyelopathy (CCSM). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Twenty dogs with CCSM. METHODS: Medical records of dogs treated by dorsal laminectomy for CCSM at North Carolina State University and Colorado State University between 1989 and 1999 were reviewed. Information on signalment, onset, progression and duration of clinical signs, diagnostic testing, sites of dorsal laminectomy, postoperative complications, length of hospitalization, and the ambulatory status on discharge was recorded. A minimum follow-up of 7 months was required for inclusion in the study. Neurologic status was graded (0 to 5) preoperatively, 2 days after surgery, and at the time of the study (final score). Improvement or worsening of the neurologic status was assessed by comparison of different scores for each dog. Additional follow-up information was obtained by means of a detailed telephone questionnaire directed at both the owner and referring veterinarian. RESULTS: Mean duration of clinical signs before surgery was 4.9 months. At admission, 15 dogs were ambulatory and 5 were nonambulatory. Neurologic status worsened in 70% of dogs 2 days after surgery but improved in all but 1 dog over the long term. Mean time to optimal recovery was 3.6 months. Long-term follow-up ranged from 7 months to 9 years (mean +/- SD, 3.2 +/- 2.4 years). Four dogs had confirmed recurrence; 2 other dogs may have had recurrence. CONCLUSIONS: Dorsal cervical laminectomy is an effective treatment for CCSM in those dogs with dorsal compression or multiple sites of involvement. CLINICAL RELEVANCE: Although most dogs' neurologic status transiently worsened after surgery, long-term outcome and recurrence rates were comparable to those seen with other surgical techniques for CCSM.  相似文献   

2.
Objective: To evaluate a distractable titanium cage for the treatment of disk‐associated wobbler syndrome (DAWS). Study Design: Prospective study. Animals: Dogs (n=7) with DAWS. Methods: After total discectomy of C5–C6 and C6–C7, the median part of the vertebral body of C6 was removed with preservation of the lateral walls and dorsal cortex. The removed cancellous bone was collected. The implant was placed in the bony defect of C6. After placement, the titanium cage was distracted and affixed by 4 screws. Finally, the implant was filled and covered with cancellous bone. Dogs had follow‐up examinations at 1, 3, 6, 12, and 24 months. Six months after surgery, cervical radiographs and computed tomography (CT) were performed. Results: Although no intraoperative complications occurred, correct placement of the cage was technically challenging. Revision surgery was necessary in 2 dogs because of implant loosening and aggravation of vertebral tilting. All dogs improved after discharge from the hospital. In 1 dog, recurrence of clinical signs caused by articular facet proliferation at an adjacent intervertebral disk space occurred. Radiographs at 6 months demonstrated cage subsidence in 4 dogs. In all dogs, CT was suggestive for fusion of the bone graft with the vertebral body. Conclusions: Although results are promising, technical adaptations will be necessary to make this specific surgical technique, designed for humans, suitable for routine use in dogs.  相似文献   

3.
Objective— To evaluate the safety of the angle of insertion of bicortical implants in Doberman Pinschers affected by caudal cervical spondylomyelopathy (CCSM) using simulation on computed tomography (CT) images.
Animals— Doberman Pinschers (n=9) with dynamic spinal compression attributed to CCSM.
Methods— Dogs had CT evaluation of the cervical vertebral column. Digital images were used to evaluate the safety of bicortical implant insertion from the midline at 30, 35, and 40° inclination by drawing a line simulating implant position. Correct surgical positioning of dogs was evaluated by measuring the degree of rotation of the spine along the longitudinal axis.
Results— Insertion of an implant at 30, 35, and 40° inclination was considered safe in 42%, 59%, and 67% of selected sites. Rotation of the spine from 9° counter clockwise to 10° clockwise along the longitudinal axis occurred in 53% of the areas considered.
Conclusions— These results suggest that bicortical implants in the caudal cervical area in Doberman Pinschers affected by CCSM carry a high risk of vertebral canal and intervertebral foramina violation.
Clinical Relevance— Bicortical implants inserted at 30 and 35° in the caudal cervical area in Doberman Pinschers affected by CCSM carry a high risk of vertebral canal and intervertebral foramina violation. CT planning for individual dogs can facilitate selection of the appropriate insertion plane and vertebral column rotation needs to be considered in surgical planning.  相似文献   

4.
Objective— To evaluate the use of a modified K-wire spacer for maintaining intervertebral distraction after ventral decompression and during stabilization as a treatment for disc-associated wobbler syndrome in large breed dogs.
Study Design— A retrospective study.
Animals— Dogs (n=7) with disc-associated wobbler syndrome.
Methods— Medical records (2003–2006) of dogs treated by a modified surgical method were evaluated. Data retrieved were signalment, onset and duration of clinical signs, neurologic abnormalities, diagnostic methods, surgical procedure, immediate, and long-term (≥1 year) postoperative clinical and radiographic outcome.
Results— Mean duration of clinical signs was 4.8 months. Neurologic signs included ataxia (2), ambulatory tetraparesis (2), and non-ambulatory tetraparesis (3). Three dogs had disc protrusion in 2 sites, 2 dogs had the procedure in 1 location and stabilization of both affected sites. All dogs improved dramatically and remained for 1–3 years. One dog had recurrence of cervical discomfort 13 months later.
Conclusions— Despite the limited number of dogs, overall initial successful outcome with only 1 dog having mild recurrence 13 months later supports further use and evaluation of this technique.
Clinical Relevance— Distraction using a K-wire spacer after ventral decompression followed by stabilization should be considered in dogs with disc-associated wobbler syndrome to prevent collapse of the intervertebral space.  相似文献   

5.
OBJECTIVE: To determine long-term (> 6 months) outcome of dogs with paraplegia and loss of hind limb deep pain perception (DPP) resulting from intervertebral disk herniation or trauma. DESIGN: Retrospective study. ANIMALS: 87 dogs. PROCEDURE: Outcome was determined as successful or unsuccessful. The association of neuroanatomic localization, breed, age, weight, sex, and (for dogs with intervertebral disk herniation) speed of onset of signs and duration of paraplegia prior to surgery with outcome was evaluated. Owners were contacted by telephone to identify long-term health problems. RESULTS: Nine of 17 dogs with traumatic injuries were treated, and 2 regained the ability to walk; none of the 17 dogs regained DPP. Sixty-four of 70 dogs with intervertebral disk herniation underwent surgery; 9 (14%) were euthanatized within 3 weeks after surgery (7 because of ascending myelomalacia), 37 (58%) regained DPP and the ability to walk, 7 (11%) regained the ability to walk without regaining DPP, and 11 (17%) remained paraplegic without DPP. Outcome was not associated with any of the factors evaluated, but speed of recovery of ambulation was significantly associated with body weight and age. Fifteen (41%) and 12 (32%) dogs that regained DPP had intermittent fecal and urinary incontinence, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the prognosis for paraplegic dogs without DPP because of trauma was guarded, while dogs with disk herniation had a better chance of recovering motor function. A third of the dogs that recovered motor function had intermittent incontinence. Persistent loss of DPP did not preclude recovery of motor function, but such dogs remained incontinent.  相似文献   

6.
Using an autogenous bone graft (obtained from the iliac crest), 4-mm cancellous bone screws, and polymethylmethacrylate, a distracted cervical spinal fusion technique was performed on 10 dogs with myelographic evidence of caudal cervical spondylomyelopathy. All dogs had evidence of dynamic soft tissue spinal cord compression, as indicated by flexion, extension, and traction myelographic views. Of the 10 dogs, 4 previously had undergone surgery by use of ventral slot or cervical disk fenestration techniques, and their neurologic status had deteriorated after the original surgery. Preoperative neurologic status of the 10 dogs included nonambulatory tetraparesis (n = 5), severe ataxia with conscious proprioceptive deficits (n = 2), and mild ambulatory ataxia with conscious proprioceptive deficits (n = 3). Five dogs had signs of various degrees of cervical pain. Clinical improvement was observed in 8 of 10 dogs--either improved neurologic status or elimination of cervical pain. Implant loosening developed in 3 dogs; 2 of them were euthanatized because of lack of neurologic improvement. Radiographic evidence of bony cervical fusion was observed during a 9- to 24-week period in 6 of the 8 surviving dogs. The distracted cervical fusion technique appears to be a valid surgical procedure to manage cervical spondylomyelopathy in those dogs in which the lesions are limited to one cervical intervertebral disk space.  相似文献   

7.
The Cloward technique for intervertebral fusion was utilized on 12 horses ranging from 3 months to 2 years of age. Of the 12 horses, 9 had been diagnosed as having equine cervical vertebral malformation (CVM) or "wobbles," and 3 were normal controls. A large hole was drilled from the ventral border of the vertebral bodies spanning the intervertebral disc and the vertebral end plates of the 2 articulating vertebrae. Frozen homologous bone dowels of slightly larger diameter from equine cadaver ilia were inserted in the holes. No adverse postoperative complication arose. Clinical improvement was seen in all horses with CVM. Three months postoperatively, partial or complete fusion was evident radiographically in 11 of the 12 horses. Necropsies were performed 3–6 months postoperatively to evaluate the quality of the fusion. Cadaver manipulation demonstrated reduced intervertebral movement at the operative site in all cases. The articulations of the equine cervical spine can be operatively fused by the Cloward technique, and surgically induced trauma is minimal. This technique can be used for stabilizing subluxations and may be applicable for treating fractures and osteolytic processes that have weakened vertebrae.  相似文献   

8.
Cervical vertebral fusion was noted radiographically in four dogs presented for signs of cervical spinal cord compression. Ventral extradural spinal cord compression was seen on myelography at intervertebral disc spaces adjacent to the fused vertebrae in two dogs and at a site removed in two dogs. At surgery, no intervertebral disc space was found in the area of fusion. No other instances of cervical vertebral fusion were identified in reviewing radiographs of 1225 other dogs with cervical intervertebral disc extrusion evaluated at our hospital. Clinical signs resolved in all dogs after surgical removal of extruded intervertebral disc material. Information from these four dogs suggest vertebral fusion may predispose adjacent discs to herniation.  相似文献   

9.
A study was undertaken to compare the efficacy of two surgical techniques for the treatment of caudal cervical spondylomyelopathy (CCSM): ventral decompression (slot) and vertebral distraction and stabilisation with a screw and washer (screw/washer). Twenty-eight dobermanns managed surgically for disc-associated CCSM during a four-year period were studied retrospectively. The maximum postoperative period was 40 months. Cases were excluded if a minimum follow-up of 24 months after surgery could not be made. A 'slot' took a longer time to perform and had a higher rate of immediate postoperative deterioration. Duration of hospital stay was similar for both procedures. At six months after surgery the two techniques were comparable; 12/14 (screw/washer) and 13/14 (slot) patients were deemed to have a satisfactory outcome. Recurrence of cervical spinal cord disease was higher in the screw/washer dogs. At one year after surgery the recurrence rate was zero (slot) and 5/14 (screw/washer), respectively. At two years after surgery 4/14 of the slot dogs had deteriorated compared to 7/14 of the screw/washer dogs. Where Investigated, the cause of deterioration was either a domino disc lesion or vertebral endplate collapse and dorsal displacement of the screw and washer.  相似文献   

10.
O bjectives : To describe the clinical and magnetic resonance imaging features of cervical vertebral malformation-malarticulation in Bernese mountain dogs.
M ethods : Seven Bernese mountain dogs (four males and three females) were diagnosed with cervical vertebral malformation-malarticulation by magnetic resonance imaging. The following data were evaluated retrospectively: (1) abnormalities of the cervical vertebral column and spinal cord, (2) spinal cord compression, (3) intervertebral disc degeneration and herniation, (4) severity of clinical signs pretreatment and after treatment, (5) type of treatment and (6) outcome.
R esults : Spin echo T1-weighted and T2-weighted images disclosed multi-level, extradural compressive spinal cord lesions (ventral, dorsolateral or both) spanning from intervertebral disc spaces C3-4 to C6-7. In all seven dogs, T2-weighted images disclosed one or more intramedullary hyperintensities associated with extradural spinal cord compression. Surgery was performed in five dogs. Two dogs were managed medically. The prognosis for surgical or conservative management in Bernese mountain dogs was similar to cervical vertebral malformation-malarticulation in other breeds.
C linical S ignificance : Cervical vertebral malformation-malarticulation is an important differential diagnosis for young to middle-aged Bernese mountain dogs with a C1-5 or C6-T2 neuroanatomic localisation. Dorsolateral spinal cord compression associated with articular process hypertrophy was the most common feature of cervical vertebral malformation-malarticulation in the seven Bernese mountain dogs evaluated.  相似文献   

11.
OBJECTIVE: To describe a surgical technique involving distraction and stabilization of the lumbo-sacral vertebral segment using an external skeletal fixator in dogs with lumbosacral instability caused by discospondylitis. STUDY DESIGN: Retrospective clinical study. ANIMALS: Four client-owned dogs. METHODS: Medical records of all dogs diagnosed with discospondylitis from 1994 to 1997 were identified and reviewed. Four dogs with lumbosacral discospondylitis requiring surgical treatment were then specifically studied. Surgical technique, clinical signs, preoperative diagnostic investigation, radiographic findings, and the results of short-term and long-term reevaluations were recorded. RESULTS: Twelve dogs with discospondylitis were identified, 4 of which had lumbosacral discospondylitis. These 4 dogs underwent surgical distraction and stabilization because they failed to respond to medical treatment. Three dogs received a cancellous bone graft between L7 and S1 and had rapid interbody fusion of this vertebral segment. The dog that did not receive a graft did not have interbody fusion at the time of fixator removal. This did not affect the final clinical outcome. Lumbosacral pain and neurological deficits present before surgery rapidly subsided after the procedure. All dogs received concurrent antibiotic treatment for a minimum of 4 weeks. All dogs were clinically normal at the time of fixator removal and all continued to do well during the follow-up period (8-48 months; mean, 27.5 months). CONCLUSION AND CLINICAL RELEVANCE: Lumbosacral discospondylitis may not respond well to conservative treatment because of the mobility of the affected space. Surgical treatment involving distraction and stabilization to obtain intervertebral fusion is very effective in treating lumbosacral instability caused by discospondylitis.  相似文献   

12.
OBJECTIVE: To describe a surgical technique for, and outcome after, treatment of radial fractures with biodegradable self-reinforced polylactide plates and metal screws, and external coaptation. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Eleven Toy breed dogs. METHODS: Radial fractures were repaired by application of a single or 2 stacked biodegradable self-reinforced polylactide plates (poly-L/D, L-lactide, stereocopolymer [LL-and DL-lactide ratio 70/30]; SR-PLA (70/30) implants) secured with metal screws, and light-weight external coaptation. Healing was evaluated clinically and by radiography at 2, 4, 6, 8, 9, 12, 24-26 weeks, and at 1 and 2 years. Owners were interviewed 3 years after surgery. RESULTS: Radial fracture lines disappeared within 4-14 weeks in 10 dogs; an implant failed in 1 dog. Ambulation was excellent for healed fractures. Excessive skin tension led to removal of implants in 1 dog and suture repair in another dog. No foreign body reaction from implant degradation was observed and the plate was usually no longer palpable at 2 years. One dog had a fracture through a screw hole at 1 year. CONCLUSION: Healing and complication rates after repair of radial fractures with SR-PLA (70/30) plates were considered similar or better than reported after repair with metallic plates or external fixation in Toy breed dogs. No radiographic signs of osteopenia were identified under the plate during follow-up. CLINICAL RELEVANCE: Biodegradable polylactide plates could be considered as an alternative to metal plates for radial fracture repair in Toy breed dogs, however available plates are likely not strong enough when used as a single plate. Implant removal is usually not needed.  相似文献   

13.
Objective : To describe clinical and magnetic resonance imaging features in dogs with compressive cervical myelopathy due to acute suspected hydrated nucleus pulposus extrusion. Design : Retrospective case series. Animals : Ten dogs with compressive cervical myelopathy caused by acute suspected hydrated nucleus pulposus extrusion. Materials and Methods : Medical records and magnetic resonance images of dogs evaluated from 2005 through 2010 were reviewed. The inclusion criteria were clinical signs compatible with cervical myelopathy, magnetic resonance imaging of the spine performed within 48 hours after onset, magnetic resonance imaging findings consistent with compressive suspected hydrated nucleus pulposus extrusion, complete medical records and follow‐up information. Results : Six dogs were presented with acute onset tetraplegia and four dogs with acute onset of nonambulatory tetraparesis. Compromised respiratory function was present in three dogs. Compressive suspected hydrated nucleus pulposus extrusion was found on magnetic resonance imaging at the C4‐C5 (n=6), C3‐C4 (n=3) and C5‐C6 (n=1) intervertebral disc spaces. Seven dogs underwent surgical treatment and three dogs were treated conservatively. All dogs except one regained ambulatory status within two weeks after the onset, and had a favourable outcome. Clinical Significance : Compressive myelopathy caused by acute suspected hydrated nucleus pulposus extrusion has not been reported previously and, even though neurological deficits can be severe on presentation, outcome is favourable.  相似文献   

14.
A transvertebral screw and interbody washer technique was used to stabilise the vertebrae and maintain the intervertebral space in 34 adult dobermann pinschers with cervical spondylopathy. The long term success of the procedure was 50 per cent. Pre-operatively three dogs were considered mildly ataxic, 16 moderately ataxic, 13 severely ataxic and two non-ambulatory. Thirty dogs had radiographic changes of calcified disc, vertebral malalignment or narrow intervertebral disc space and all dogs had myelographic abnormalities in the caudal cervical spine. Vertebral malalignment and narrow intervertebral space correlated closely with myelographic cord compression. However, compressive lesions were not identified in 11 cases on plain films. Follow-up was available on 30 dogs of which 25 showed neurological improvement. This was temporary in 10 cases which were destroyed two weeks to three years following surgery.  相似文献   

15.
Objective : To evaluate retrospectively the efficacy of syringosubarachnoid shunt for the management of syringohydromyelia/syringomyelia. Methods : Eleven dogs diagnosed with syringohydromyelia/syringomyelia by magnetic resonance imaging associated with Chiari‐like malformation underwent placement of a syringosubarachnoid shunt at the cervical (nine dogs) or lumbar (two dogs) spinal cord. In one dog, a suboccipital decompression (foramen magnum decompression) was performed 4 months before inserting a syringosubarachnoid shunt. All dogs were evaluated neurologically a few hours after surgery, 2 weeks and 6 months postoperatively. Retrospectively, cases were assigned a preoperative and postoperative pain score. Results : There were no intra‐ or peri‐operative complications. One dog (9%) was euthanased 5 weeks after surgery. Progressive neurological improvement was observed in nine dogs (81·8%) 2 weeks and 6 months postoperatively. No clinical improvement was seen in another dog (9%). One dog (9%) had replacement of the syringosubarachnoid shunt. Seven dogs (63·6%) were still alive 1 to 4 years (mean, 2·6 years) after surgery. Clinical Significance : Placement of a syringosubarachnoid shunt in the presence of a sufficiently large syrinx appears to be beneficial in dogs with Chiari‐like malformation and associated syringohydromyelia/syringomyelia.  相似文献   

16.
OBJECTIVE: To describe an intraoperative ultrasound imaging technique during dorsal laminectomy in 2 dogs with caudal cervical vertebral instability and malformation (CCVIM, "Wobbler syndrome"). STUDY DESIGN: Clinical case report. SAMPLE POPULATION: Two dogs with CCVIM. RESULTS: On neurologic examination there was tetraparesis with upper motor neuron signs in the thoracic limbs and lower motor neuron signs in the pelvic limbs in dog 1, and hyperreflexia of the rear limbs, normoreflexia of the right front limb, and hyporeflexia of the left front limb of dog 2. Both dogs had signs of marked cervical pain and radiographic signs of cervical spinal cord compression. Intraoperative ultrasonography of the spinal cord revealed protruding intervertebral disc at C5-6 (dog 1) and C6-7 (dog 2), and the parallel borders of the spinal cord and central canal after decompression. Continuous dorsal laminectomy (CDL) resulted in improvement over 16 months (dog 1) and 20 months (dog 2). CONCLUSIONS: Intraoperative ultrasonographic imaging of the cervical spinal cord after CDL was helpful in determining adequate decompression (postlaminectomy) of the spinal cord in relation to the ventral and lateral compressive component(s) and to image the protruding intervertebral disc. CLINICAL RELEVANCE: Intraoperative ultrasonography can be used to provide valuable information on the spinal cord and surrounding soft tissues for the neurosurgeon.  相似文献   

17.
Spondylosis deformans and diffuse idiopathic skeletal hyperostosis (DISH) are usually incidental findings and in most dogs are either asymptomatic or associated with mild clinical signs. Severe spondylosis deformans and DISH can result in complete bony fusion of consecutive vertebral segments. One of the recognised complications following vertebral fusion in human patients is the development of adjacent segment disease, which is defined as degenerative changes, most commonly degenerative intervertebral disc disease, in the mobile vertebral segment neighboring a region of complete vertebral fusion. A similar syndrome following cervical fusion in dogs has been termed the domino effect. The purpose of this retrospective study was to investigate the hypothesis that vertebral fusion occurring secondary to spondylosis deformans or DISH in dogs would protect fused intervertebral disc spaces from undergoing degeneration, but result in adjacent segment disease at neighbouring unfused intervertebral disc spaces. Eight dogs with clinical signs of thoracolumbar myelopathy, magnetic resonance imaging of the thoracolumbar vertebral column, and spondylosis deformans or DISH producing fusion of > or = 2 consecutive intervertebral disc spaces were evaluated. Vertebral fusion of > or = 2 consecutive intervertebral disc spaces was correlated (P = 0.0017) with adjacent segment disease at the neighbouring unfused intervertebral disc space. Vertebral fusion appeared to protect fused intervertebral disc spaces from undergoing degeneration (P < 0.0001). Adjacent segment disease should be considered in dogs with severe spondylosis deformans or DISH occurring in conjunction with a thoracolumbar myelopathy.  相似文献   

18.
Objective— To evaluate use of a surgical technique commonly used in humans for treatment of cervical spondylotic myelopathy (CSM) in dogs.
Design— Prospective case series.
Animals— Dogs with CSM (n=10).
Methods— Dogs weighing >30 kg that had CSM at 1 vertebral articulation were eligible for inclusion. Dogs had vertebral column distraction/fusion performed using a cortical ring allograft, cancellous autograft, and a spinal locking plate. Dogs were evaluated temporally by repeat neurological examinations and by client perception of postsurgical outcome, determined by telephone interview.
Results— Nine dogs survived the immediate postoperative period. Seven of 8 dogs had moderate to complete improvement without recurrence (mean follow-up, 2.48 years). The most common postsurgical complications were screw loosening (n=4) and plate shifting (2), neither of which required surgical revision. One dog had pseudoarthrosis that may have negatively impacted outcome.
Conclusion— Treatment of single level CSM in dogs with ring allograft and a spinal locking plate system may lead to successful outcomes. The major problems encountered with included cost of the implants and adjusting the system designed for humans to fit the vertebral column of a dog.
Clinical Relevance— For dogs with CSM at a single level, the use of a spinal locking plate in combination with a cortical ring allograft can be an effective surgical treatment. Costs of the implants as well as anatomic differences in dogs make this type of surgery less appealing.  相似文献   

19.
A Thoroughbred yearling was presented with neurological, radiographic, and myelographic abnormalities consistent with cervical vertebral stenotic myelopathy. Surgical correction was performed by using ventral cervical interbody fusion at 3 intervertebral spaces. The patient recovered uneventfully from surgery. The neurological status remained unchanged initially; however, significant improvement was noted 37 weeks postoperatively.  相似文献   

20.
OBJECTIVE: To evaluate long-term clinical outcome in dogs with upper airway obstruction treated with laryngeal web resection and mucosal apposition. DESIGN: Retrospective case series. ANIMALS: 15 client-owned dogs with laryngeal web formation. PROCEDURES: Medical records of dogs with laryngeal webs treated with a single procedure of web resection with mucosal apposition by use of a ventral laryngotomy were reviewed. Signalment, history, clinical signs, intraoperative complications, postoperative complications, and hospitalization time were recorded. Owners were interviewed 6 months to 6 years after surgery. RESULTS: Most dogs had a history of oral ventriculocordectomy. Duration of clinical signs ranged from 3 months to 3 years. The most common clinical sign reported was exercise intolerance. Postoperative complications were observed in 4 dogs. Follow-up information was available in 10 dogs, and clinical outcome was classified as excellent in 7 and good in 3. CONCLUSIONS AND CLINICAL RELEVANCE: A single surgical procedure of web resection with mucosal apposition for the treatment of laryngeal web formation in dogs resulted in low morbidity and was associated with a good to excellent outcome.  相似文献   

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