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1.
Caudal lumbar disk herniations (i.e., third lumbar [L3] to seventh lumbar [L7] intervertebral spaces) represent approximately 15% of surgically treated thoracolumbar disk herniations in dogs. A retrospective case-control study was conducted to determine the postoperative outcome of this subset of dogs in the authors' neurosurgical practice. Medical records (1985 through 1996) were reviewed for dogs with caudal lumbar disk herniation confirmed at surgery. Thirty-six cases were identified. For each case, two dogs that underwent surgical treatment for upper motor neuron thoracolumbar disk herniation (tenth thoracic [T10] to L3 intervertebral spaces) were selected as controls. Probabilities of functional recovery for cases and controls were 81% and 85%, respectively (p value of 0.49). In dogs with caudal lumbar disk herniation, complete sensorimotor loss was the only significant predictor of functional recovery (p value of 0.005). Disk herniations that occur at the thoracolumbar junction and those that occur in the caudal lumbar region should not be considered to be different in terms of surgical treatment and postoperative outcome. The lower motor neuron signs that often accompany caudal lumbar disk herniation reflect the site of spinal cord injury and do not necessarily predict a poor prognosis.  相似文献   

2.
OBJECTIVES: To evaluate a population of chondrodystrophic dogs treated for Hansen type 1 intervertebral disk (IVD) disease by surgical decompression with or without prophylactic fenestration and determine the rate and location of surgically confirmed recurrence of intervertebral disk extrusion. ANIMALS: 265 dogs. STUDY DESIGN: Retrospective study. PROCEDURES: Medical records of dogs that underwent spinal decompression between 1995 and 1999 were reviewed. RESULTS: 3 (4.9%) dogs were euthanatized or died prior to discharge. Fenestration was performed in 252 dogs, including 37 (14.7%) at the site of decompression only, 48 (19%) at 3 to 4 disk spaces, and 167 (66%) at 5 to 7 disk spaces. There were 12 instances of recurrent disk extrusion confirmed by removal of disk at a second surgery 3.5 to 33 months after the first surgery. Recurrence was always at a new disk space, and rates did not significantly differ between dogs that underwent single or multiple fenestrations. Two recurrences were at a previously fenestrated disk space. Seven recurrences were at a site immediately adjacent to a fenestrated disk space, and 5 recurrences were at L4-5. CONCLUSIONS AND CLINICAL RELEVANCE: Prophylactic fenestration is generally successful in preventing future disk extrusions at fenestrated disk spaces. Prospective evaluation is still required to determine whether fenestration decreases the overall rate of recurrence. Prophylactic fenestration could promote disk extrusion at adjacent, nonfenestrated disk spaces. This could have a substantial clinical impact if recurrence develops at L4-5.  相似文献   

3.
OBJECTIVE: To determine magnetic resonance imaging (MRI) abnormalities in dogs with intervertebral disk disease (IVDD) and develop a classification scheme for IVDD in dogs based on MRI findings. DESIGN: Retrospective case series. ANIMALS: 69 dogs. PROCEDURE: Medical records of dogs admitted because of thoracolumbar IVDD in which MRI of T9 through L7 had been performed were reviewed. RESULTS: A total of 759 intervertebral disk spaces were examined. Of these, 342 (45.1%) were classified as having a normal MRI appearance; the remaining 417 (54.9%) had various types of IVDD. Disk degeneration was identified in 276 disk spaces in 56 dogs, bulging of the intervertebral disk was identified in 37 disk spaces in 24 dogs, disk protrusion was identified in 54 disk spaces in 32 dogs, and disk extrusion was identified in 50 disk spaces in 48 dogs. Cartilage endplate changes were identified in 35 vertebrae in 17 dogs, and increased signal intensity of the spinal cord was identified in 21 dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Four types of IVDD (disk degeneration, bulging of the intervertebral disk, disk protrusion, and disk extrusion) were identified on the basis of MRI findings in dogs with thoracolumbar IVDD. We recommend that a standardized nomenclature be adopted for the various types of thoracolumbar IVDD in dogs.  相似文献   

4.
OBJECTIVES: To investigate the influence of different approach angles on the amount of nucleus pulposus removed during intervertebral disc fenestration in dogs. METHODS: Twenty cadavers of beagle dogs were randomly divided into four groups: a control group and three treatment groups in which intervertebral fenestration was performed using either a dorsal, dorsolateral or lateral approach between the 12th thoracic and second lumbar spaces. The volume of nucleus pulposus, the weight of the residual nucleus pulposus and the angle of the working sector were measured. The ratio of the residual nucleus pulposus weight to the nucleus pulposus volume was used to evaluate the efficacy of the performed fenestration. Data were analysed with Kruskal-Wallis analysis of variance between groups on ranks with correction for ties and Bonferroni correction for multiple comparisons. Correlation between ratio and working angle was calculated using a Spearman's rank test (P<0.05). RESULTS: The calculated ratio of nuclear weight to volume was significantly less in the lateral approach group than that in the other groups. The working sector was widest in the dorsolateral approach group, but this did not correlate with efficient fenestration. CLINICAL SIGNIFICANCE: Using the lateral approach for intervertebral disc fenestration may increase the efficiency of the fenestration procedure.  相似文献   

5.
OBJECTIVE: To evaluate use of electroacupuncture combined with standard Western medical treatment versus Western medical treatment alone for treatment of thoracolumbar intervertebral disk disease in dogs. DESIGN: Prospective controlled study. ANIMALS: 50 dogs with signs of thoracolumbar intervertebral disk disease. PROCEDURES: Dogs were randomly allocated to 1 of 2 treatment groups and classified as having grade 1 to 5 neurologic dysfunction. Dogs in group 1 received electroacupuncture stimulation combined with standard Western medical treatment; those in group 2 received only standard Western medical treatment. A numeric score for neurologic function was evaluated at 4 time points to evaluate effects of treatments. RESULTS: Time (mean +/- SD) to recover ambulation in dogs with grade 3 and 4 dysfunction in group 1 (10.10 +/- 6.49 days) was significantly lower than in group 2 (20.83 +/- 11.99 days). Success (able to walk without assistance) rate for dogs with grade 3 and 4 dysfunction in group 1 (10/10 dogs) was significantly higher than that of similarly affected dogs in group 2 (6/9 dogs). Dogs without deep pain perception (grade 5 dysfunction) had a success (recovery of pain sensation) rate of 3 of 6 and 1 of 8 in groups 1 and 2, respectively, but the difference was not significant. Overall success rate (all dysfunction grades) for group 1 (23/26; 88.5%) was significantly higher than for group 2 (14/24; 58.3%). CONCLUSIONS AND CLINICAL RELEVANCE: Electroacupuncture combined with standard Western medical treatment was effective and resulted in shorter time to recover ambulation and deep pain perception than did use of Western treatment alone in dogs with signs of thoracolumbar intervertebral disk disease.  相似文献   

6.
The medical records of 10 cats diagnosed with intervertebral disk disease were reviewed. No apparent sex or breed predilection was found. The mean age of cats in the study was 9.8 years. Clinical signs included back pain, difficulty ambulating, and incontinence. Radiographs revealed narrowed disk spaces, mineralized intervertebral disks, and evidence of extradural compression on myelography or computed tomography. All intervertebral disk herniations occurred in the thoracolumbar spine, with a peak incidence at the fourth to fifth lumbar (L4-L5) intervertebral disk space. Eight cats had Hansen's type I intervertebral disk herniation. Surgery was performed in seven cats. All cats judged to have an excellent outcome had undergone surgical decompression.  相似文献   

7.
OBJECTIVE: To assess risk factors for recurrence of clinical signs associated with thoracolumbar intervertebral disk disease (IVDD) in dogs that had decompressive laminectomy without attempted prophylactic treatment of other disk spaces. DESIGN: Retrospective study. ANIMALS: 229 dogs. PROCEDURE: Medical records of dogs that had decompressive laminectomy without prophylactic fenestration for a first episode of IVDD and were available for follow-up were reviewed. Information on 7 clinical and 8 radiographic potential risk factors were recorded. RESULTS: Clinical signs associated with recurrence of IVDD developed in 44 (19.2%) dogs. Ninety-six percent of recurrences developed within 3 years after surgery. Recurrence developed in 25% of Dachshunds and 15% of dogs of other breeds combined. Number of opacified disks was a significant risk factor for recurrence. Risk increased with number of opacified disks in an almost linear manner; each opacified disk increased risk by 1.4 times. Dogs with 5 or 6 opacified disks at the time of first surgery had a recurrence rate of 50%. CONCLUSIONS AND CLINICAL RELEVANCE: When all likely episodes of recurrence are considered and a long follow-up period is achieved, true rate of recurrence of IVDD appears to be higher than in many previous reports. Dogs with multiple opacified disks at the time of first surgery should be considered a high-risk subpopulation.  相似文献   

8.
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9.
The clinical outcomes in 112 dogs weighing less than 35 pounds that were presented with cervical intervertebral disk protrusions were retrospectively evaluated. Although the second to third cervical (C2 to C3) intervertebral space was the most common site (27%) of disk protrusion, 57% of disk protrusions presented were caudal to the fourth cervical (C4) vertebra. Dogs with cranial intervertebral disk protrusions, including the C2 to C3 and C3 to C4 intervertebral disk spaces, responded favorably to ventral slot decompression. By comparison, caudal intervertebral disk protrusions (within the C4 to the seventh cervical [C7] intervertebral disk spaces) responded less favorably to ventral slot decompression, demonstrating significantly more severe clinical effects in motor function, comfort, recovery, and long-term outcome following surgery. Significant improvement in clinical results was seen in caudal disk protrusions when additional surgical distraction and stabilization were provided following ventral slot decompression.  相似文献   

10.
Cervical intervertebral disk disease is commonly treated surgically by ventral decompression through a ventral slot. Nine dogs with documented vertebral subluxation following surgical creation of a ventral slot are reported. The location of the subluxation was at the fourth cervical (C4) to fifth cervical (C5) intervertebral space in two dogs, C5 to sixth cervical (C6) intervertebral space in four dogs, and C6 to seventh cervical (C7) intervertebral space in three dogs. The ventral slot width to vertebral body width ratio ranged from 0.39 to 0.80, with the ratio being 0.50 or greater in seven of eight cases evaluated radiographically. Surgical reduction and stabilization were performed in seven of nine dogs.  相似文献   

11.
Case histories of 105 dogs that were treated for cervical intervertebral disk disease (IVDD) were studied retrospectively. To compare with previous data, dogs were grouped by age, gender, and breed. Dogs were also grouped by clinical signs of disease, and by presence and location of radiologic change. The age range of cases of cervical IVDD was 1 to 13 years (mean, 6.3 years). Fifty-nine percent of dogs treated for cervical IVDD were females, but the proportion of diseased females was similar to females in total hospital admissions. Twenty-eight breeds of dogs were treated for cervical IVDD. Dachshunds and Beagles were significantly over represented (P less than or equal to 0.001). However, gender-breed interaction was not observed. Prevalence of radiologic evidence of disk disease was detected at the following levels of the vertebral column: C2-3, 29%; C3-4, 24%; C4-5, 21%; C5-6, 15%; C6-7, 9%; and C7-T1, 2%. Significant difference was not observed in prevalence of cervical IVDD affecting the first 4 disk spaces. However, prevalence of cervical IVDD at C7-T1 was significantly less than that involving the first 4 disk spaces (P less than 0.02), and the space at C6-7 was significantly less affected than were the first 3 spaces (P less than 0.08). Significant association was not evident between clinical signs (pain and neurologic deficits) and radiologic signs of IVDD, although neurologic deficits were more likely to be observed in association with radiologic signs than with signs of pain.  相似文献   

12.
Objective— To describe the influence of fenestration at the disc herniation site on recurrence in thoracolumbar disc disease of chondrodystrophoid dogs.
Study Design— Prospective clinical study.
Animals— Chondrodystrophic dogs (n=19).
Methods— Dogs were divided into 2 groups: group 1 (9 dogs) had thoracolumbar disc extrusion (Hansen type I) treated by hemilaminectomy and concomitant fenestration of the affected intervertebral disc and group 2 (10 dogs) had hemilaminectomy without fenestration. All dogs had 3 magnetic resonance imaging (MRI) examinations: preoperatively, immediately postoperatively to assess removal of herniated disc material, and again 6 weeks after surgery.
Results— There were 13 male and 6 female dogs; mean age, 7.1 years. Thoracolumbar disc herniation was confirmed with MRI. Immediate post surgical MRI revealed that the herniated disc removal was complete in all but 1 dog and that fenestration did not lead to complete removal of nucleus pulposus within the intervertebral disc space. On the 3rd MRI examination, none of the group 1 dogs had further disc material herniation at the fenestrated site. Six of the 10 group 2 dogs had a recurrence of herniation leading to clinical signs in 3 dogs (pain in 2 dogs, paresis in 1 dog).
Conclusion— In thoracolumbar disc herniation, fenestration of the affected intervertebral disc space prevents further extrusion of disc material.
Clinical Relevance— Fenestration reduces the risk of early recurrence of disc herniation and associated postoperative complications.  相似文献   

13.
OBJECTIVE: To determine the effect that ventral intervertebral disk fenestration has on the sagittal range of motion about the C5-C6 intervertebral space. STUDY DESIGN: A repeated measures in vitro mechanical study of spinal range of motion under controlled loading conditions before and after fenestration. SAMPLE POPULATION: A total of 10 canine cervical vertebral specimens (C4-C7) collected from clinically normal animals within 12 hours of euthanasia. METHODS: Specimens were loaded as cantilever beams fixed at C7. Weights (1 to 5 kg) were progressively applied to C4 to produce flexion or extension in the sagittal plane. Radiographs were taken at each load, 3 times before and 3 times after fenestration of the C5-C6 disk. The positions of radiodense markers embedded in the vertebrae were used to calculate flexion and extension angles and range of motion. RESULTS: Range of motion (difference between flexion and extension) and flexion and extension angles (individually) significantly increased after fenestration (P < .0001). CONCLUSION: Ventral fenestration produces sagittal instability of the C5-C6 disk space. CLINICAL RELEVANCE: In surgical fusion of caudal cervical intervertebral spaces in dogs, radiographically normal disks adjacent to the affected space are often fenestrated to facilitate distraction before surgical stabilization. This study shows that ventral fenestration produces instability of a caudal cervical intervertebral space in the model used. Such instability may contribute to the development of the secondary instability ("domino lesions") seen in some surgically treated dogs.  相似文献   

14.
Medical records of 144 small-breed dogs (< or =15 kg) and 46 medium- to large-breed dogs (>15 kg) with surgically confirmed, Hansen type I, cervical intervertebral disk extrusions were reviewed. The most common clinical presentation was cervical hyperesthesia. The most common sites affected were the second (C(2)) to third (C(3)) cervical intervertebral disk space in small-breed dogs and the sixth (C(6)) to seventh (C(7)) cervical intervertebral disk space in the larger dogs. Following surgery, 99% of the dogs had resolution of cervical hyperesthesia and were able to ambulate unassisted. Seven (4%) dogs required a second surgery; four of these were large-breed dogs.  相似文献   

15.
OBJECTIVE: To evaluate the possible association between facet joint geometry and intervertebral disk degeneration in German Shepherd Dogs. ANIMALS: 25 German Shepherd Dogs and 11 control dogs of similar body weight and condition. PROCEDURE: Facet joint angles in the caudal portion of the lumbar region of the vertebral column (L5-S1) were measured by use of computed tomography, and the intervertebral discs were evaluated microscopically. The relationship between facet joint geometry and disk degeneration was evaluated by use of statistical methods. RESULTS: German Shepherd Dogs had significantly more facet joint tropism than control dogs, but an association with disk degeneration was not found. However, German Shepherd Dogs had a different facet joint conformation, with more sagittally oriented facet joints at L5-L6 and L6-L7 and a larger angle difference between the lumbar and lumbosacral facet joints, compared with control dogs. CONCLUSIONS AND CLINICAL RELEVANCE: A large difference between facet joint angles at L6-L7 and L7-S1 in German Shepherd Dogs may be associated with the frequent occurrence of lumbosacral disk degeneration in this breed.  相似文献   

16.
The objective of the study was to determine the effect of the dispersed or nondispersed form of the extruded disk material (EDM) on the neurological status and surgical outcomes in Hansen thoracolumbar intervertebral disk disease Type I (IVDD-I). Medical records of 40 dogs with IVDD-I were reviewed, including neurologic status on admission, findings on magnetic resonance imaging (MRI), intraoperative findings, and surgical outcomes. In MRI evaluations, EDM was on the right in 16, on the left in 18, and centrally in 6 cases; in all cases, findings were confirmed by surgery. Extruded disk material was localized and classified as dispersed disk (DD) or nondispersed disk (NDD) according to its dispersion in the epidural space on MRI. Twenty-five dogs had DD and 15 had NDD on both MRI and surgery. There was no significant difference between DD and NDD in preoperative neurological status and surgical outcomes (P > 0.05).  相似文献   

17.
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18.
OBJECTIVE: To determine whether body weight, body condition score, or various body dimensions were associated with acute thoracolumbar intervertebral disk extrusion or protrusion and whether any of these factors were associated with severity of clinical signs in Dachshunds. DESIGN: Cross-sectional clinical study. ANIMALS:75 Dachshunds with (n = 39) or without (36) acute thoracolumbar intervertebral disk extrusion or protrusion. PROCEDURES: Signalment, various body measurements, body weight, body condition score, and spinal cord injury grade were recorded at the time of initial examination. RESULTS: Mean T1-S1 distance and median tuber calcaneus-to-patellar tendon (TC-PT) distance were significantly shorter in affected than in unaffected dogs. A 1-cm decrease in T1-S1 distance was associated with a 2.1-times greater odds of being affected, and a 1-cm decrease in TC-PT distance was associated with an 11.1-times greater odds of being affected. Results of multivariable logistic regression also indicated that affected dogs were taller at the withers and had a larger pelvic circumference than unaffected dogs, after adjusting for other body measurements. Results of ordinal logistic regression indicated that longer T1-S1 distance, taller height at the withers, and smaller pelvic circumference were associated with more severe spinal cord injury. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that certain body dimensions may be associated with acute thoracolumbar intervertebral disk extrusion or protrusion in Dachshunds and, in affected dogs, with severity of neurologic dysfunction.  相似文献   

19.
OBJECTIVE: To determine complications and neurologic outcomes associated with dexamethasone administration to dogs with surgically treated thoracolumbar intervertebral disk herniation, compared with dogs not receiving dexamethasone. DESIGN: Retrospective case series. ANIMALS: 161 dogs with surgically confirmed thoracolumbar disk herniation. PROCEDURES: Medical records from 2 hospitals were used to identify dogs that had received dexamethasone < 48 hours prior to admission (dexamethasone group dogs), dogs that received glucocorticoids other than dexamethasone < 48 hours prior to admission (other-glucocorticoid group dogs), and dogs that received no glucocorticoids (nontreatment group dogs). Signalment, neurologic injury grade, laboratory data, and complications were extracted from medical records. RESULTS: Dexamethasone group dogs were 3.4 times as likely to have a complication, compared with other-glucocorticoid or nontreatment group dogs. Dexamethasone group dogs were 11.4 times as likely to have a urinary tract infection and 3.5 times as likely to have diarrhea, compared with other-glucocorticoid or nontreatment group dogs. No differences in neurologic function at discharge or recheck evaluation were detected among groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that treatment with dexamethasone before surgery is associated with more adverse effects, compared with treatment with glucocorticoids other than dexamethasone or no treatment with glucocorticoids, in dogs with thoracolumbar intervertebral disk herniation. In this study population, no difference in outcome was found among groups. These findings suggest that the value of dexamethasone administration before surgery in dogs with thoracolumbar disk herniation should be reconsidered.  相似文献   

20.
Intervertebral disk disease is common in humans and dogs but is rarely reported in horses. In this case report, we describe an 11-year-old American Saddlebred gelding with a 2-month history of pain and progressive neurological abnormalities (ataxia, conscious proprioceptive deficits involving all four limbs, toe dragging, and restricted neck flexion) while being worked as a Saddleseat show horse. Radiographs of the cervical spine showed a loss of the intervertebral disk space at C6–C7. At necropsy, nearly complete loss of the intervertebral disk at C6–C7 was seen, with marked eburnation and subchondral sclerosis of the adjacent vertebral endplates that were confirmed by histopathology. Many of the marrow spaces of the affected vertebral bodies were filled with cartilage and others contained variable amounts of fibrous connective tissue (myelofibrosis). To our knowledge, these pathological lesions are rarely reported in the literature and appear to represent a chronic, end-stage phase of cervical vertebral stenosis.  相似文献   

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