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1.
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2.
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   

3.
Objective— To investigate causes of the lack of clinical improvement after thoracolumbar disc surgery. Study Design— Case–control magnetic resonance imaging (MRI) study. Animals— Chondrodystrophic dogs with acute thoracolumbar disc disease treated by hemilaminectomy: 10 that had no short‐term clinical improvement and 12 with “normal” clinical improvement. Methods— Dogs that had surgery for treatment of intervertebral disc extrusion (2003–2008) where thoracolumbar disc disease was confirmed by MRI were evaluated to identify dogs that had lack of clinical improvement after surgery. Ten dogs with delayed recovery or clinical deterioration were reexamined with MRI and compared with 12 dogs with normal recovery and MRI reexamination after 6 weeks (control group). Results— Of 173 dogs, 10 (5.8%) had clinical deterioration within 1–10 days after surgery. In 8 dogs, residual spinal cord compression was identified on MRI. Bleeding was present in 1 dog. In 3 dogs, the cause was an incorrect approach and insufficient disc material removal. In 3 dogs, recurrence occurred at the surgical site. In 1 dog, the centrally located extruded material was shifted to the contralateral side during surgery. These 8 dogs had repeat surgery and recovery was uneventful. In 2 dogs, deterioration could not be associated with a compressive disc lesion. Hemorrhagic myelomalacia was confirmed by pathologic examination in 1 dog. The other dog recovered after 6 months of conservative management. Conclusion— Delayed postsurgical recovery or deterioration is commonly associated with newly developed and/or remaining compressive disc lesion. Clinical Relevance— We recommend early MRI reexamination to assess the postsurgical spinal canal and cord, and to plan further therapeutic measures in chondrodystrophic dogs with delayed recovery after decompressive hemilaminectomy for thoracolumbar disc disease.  相似文献   

4.
Objective: To compare the incidence of clinically evident post-operative complications, financial cost and length of hospital stay for Dachshunds with acute intervertebral disc disease treated with decompressive surgery with and without the use of methylprednisolone sodium succinate (MPSS).
Design: Retrospective clinical study
Setting: Veterinary Teaching Hospital
Animals: Dachshunds that presented to the Veterinary Hospital of the University of Pennsylvania between January 1994 and December 1999 with acute intervertebral disc disease that were treated with decompressive surgery.
Intervention: None
Measurements and Main Results: Dogs were divided into 2 groups dependent upon whether they had received MPSS. Medical records were examined for evidence of post-operative complications. Other parameters recorded included details of drugs administered (principally corticosteroids and gastrointestinal protectant drugs), length and cost of hospital stay and neurological status at 24 hours post-operatively and at suture removal. Compared to other corticosteroids, dogs receiving MPSS had a significantly higher incidence of clinically evident post-operative gastrointestinal complications, an increased use of gastrointestinal protectant drugs, and an increased cost for hospital stay (p<0.01).
Conclusions: The use of MPSS inDachshunds with acute intervertebral disc disease is associated with an increased post-operative complication rate and an increased financial cost to the client. The use of MPSS should be carefully evaluated for each patient.  相似文献   

5.
Intradural disc herniation is a rarely reported cause of neurologic deficits in dogs and few published studies have described comparative imaging characteristics. The purpose of this retrospective cross sectional study was to describe clinical and imaging findings in a group of dogs with confirmed thoracolumbar intradural disc herniation. Included dogs were referred to one of four clinics, had acute mono/paraparesis or paraplegia, had low field magnetic resonance imaging (MRI) and/or computed tomographic myelography, and were diagnosed with thoracolumbar intradural disc herniation during surgery. Eight dogs met inclusion criteria. The prevalence of thoracolumbar intradural disc herniation amongst the total population of dogs that developed a thoracolumbar intervertebral disc herniation and that were treated with a surgical procedure was 0.5%. Five dogs were examined using low‐field MRI. Lesions that were suspected to be intervertebral disc herniations were observed; however, there were no specific findings indicating that the nucleus pulposus had penetrated into the subarachnoid space or into the spinal cord parenchyma. Thus, the dogs were misdiagnosed as having a conventional intervertebral disc herniation. An intradural extramedullary disc herniation (three cases) or intramedullary disc herniation (two cases) was confirmed during surgery. By using computed tomographic myelography (CTM) for the remaining three dogs, an intradural extramedullary mass surrounded by an accumulation of contrast medium was observed and confirmed during surgery. Findings from this small sample of eight dogs indicated that CTM may be more sensitive for diagnosing canine thoracolumbar intradural disc herniation than low‐field MRI.  相似文献   

6.
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   

7.
Thoracolumbar myelopathy encompasses a number of disease processes such as intervertebral disc disease, discospondylitis, trauma, congenital malformations, neoplasia, and intramedullary spinal cord disease. Compressive disc herniations are most common in dogs and require imaging procedures such as myelography, computed tomography (CT), and/or magnetic resonance imaging (MRI) to determine the need and location for decompressive surgery. The purposes of this retrospective, cross‐sectional study were to evaluate all dogs undergoing thoracolumbar CT imaging as the initial diagnostic step between 2010 and 2015 and determine whether any of the imaging characteristics could be used to predict the need for additional imaging in the form of myelography, CT myelography, and/or MRI. A total of 555 dogs were identified in this time frame which underwent CT imaging for myelopathy of the thoracolumbar region. Various parameters including age, gender, sexual status, breed, chronicity, site of lesion, time of study, and contrast administration were evaluated. Findings indicated that 7.6% of dogs needed additional imaging after CT. Dachshunds were less likely to need additional imaging (P = 0.0111) as were patients scanned during normal business hours (P = 0.0075). Increasing age of the patient increased the likelihood of additional imaging (P = 0.0107). Dogs which did not have additional imaging performed were 21.89 times more likely to require surgery than those which did have additional imaging (P < 0.0001). Findings supported the use of CT as a first‐line imaging modality for dogs presenting with thoracolumbar myelopathy.  相似文献   

8.
This study reviews the records of all dogs that underwent dorsal decompressive laminectomy for thoracolumbar disc disease at the Angell Memorial Animal Hospital during a 2-year period. Findings as to age, breed, sex, and site of disc protrusion did not differ from those published by others. All dogs were operated on within 36 hours of the onset of inability to walk. The overall recovery rate was 80.6%. The recovery rate of dogs that had preoperative sensory perception was 89.5%, but was only 50.0% for those without sensory perception. The most important factor determining recovery rate was the presence or absence of preoperative sensory perception.  相似文献   

9.
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   

10.
OBJECTIVE: To quantify the association between intervertebral disk calcification and disk herniation in Dachshunds. DESIGN: Longitudinal study. ANIMALS: 61 Dachshunds that had been radiographically screened for calcification of intervertebral disks at 2 years of age in other studies. Thirty-seven of the dogs had survived to the time of the present study and were > or = 8 years of age; 24 others had not survived. PROCEDURES: Radiographic examination of 36 surviving dogs was performed, and information on occurrence of disk calcification at 2 years of age were obtained from records of all 61 Dachshunds. Information on occurrence of disk herniation between 2 and 8 years of age was obtained from owners via questionnaire. Associations between numbers of calcified disks and disk herniation were analyzed via maximum likelihood logistic regression. RESULTS: Disk calcification at 2 years of age was a significant predictor of clinical disk herniation (odds ratio per calcified disk, 1.42; 95% confidence interval, 1.19 to 1.81). Number of calcified disks in the full vertebral column was a better predictor than number of calcified disks between vertebrae T10 and L3. Numbers of calcified disks at > or = 8 years of age and at 2 years of age were significantly correlated. CONCLUSIONS AND CLINICAL RELEVANCE: Number of calcified disks at 2 years of age was a good predictor of clinical disk herniation in Dachshunds. Because of the high heritability of disk calcification, it is possible that an effective reduction in occurrence of severe disk herniation in Dachshunds could be obtained by selective breeding against high numbers of calcified disks at 2 years of age.  相似文献   

11.
OBJECTIVE: To determine the incidence of and risk factors for ventilatory failure in dogs undergoing surgery for treatment of cervical spinal disorders and to document ventilator management, clinical course, and long-term outcome of dogs that experienced ventilatory failure in association with cervical spinal disorders or their management. DESIGN: Retrospective study. ANIMALS: 14 dogs. PROCEDURE: Dogs with cervical spinal disorders that required positive-pressure ventilation (PPV) were identified, and signalment, concurrent diseases, neurologic status at initial examination, clinical course, pulmonary function before, during, and after PPV, management techniques, complications, and outcome were recorded. Dogs that underwent surgery and required PPV were compared with dogs that underwent cervical spinal surgery during the same period that did not require PPV. RESULTS: 14 dogs with cervical spinal disorders required PPV to treat hypoventilation, including 13 of 263 (4.9%) dogs that underwent surgery for cervical spinal disorders. Lesions between the second and fourth cervical vertebrae and treatment by means of a dorsal decompressive laminectomy were associated with a significantly increased risk of perioperative hypoventilation. Pulmonary gas exchange function was normal or nearly normal throughout the course of PPV in dogs that survived. Ten dogs survived, and 9 of the 10 regained neurologic function. All 9 dogs that regained neurologic function had deep pain perception on initial examination at the veterinary teaching hospital. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a small percentage of dogs with cervical spinal disorders may require perioperative ventilatory support. With prolonged PPV and aggressive management, a good outcome may be achieved in dogs similar to those described in the present study.  相似文献   

12.
Vertebral osteosarcoma (OSA) is the most common primary vertebral tumor in dogs, however studies examining the survival time after surgical decompression of these tumors are limited. There is also limited information regarding the benefit of adjunctive treatments such as radiation therapy or chemotherapy in these patients. The goal of this study was to determine survival time of dogs with primary vertebral OSA after palliative decompressive surgery alone and combined with radiation therapy and/or chemotherapy. Records from 22 client‐owned dogs diagnosed with primary vertebral OSA and treated with decompressive surgery were collected retrospectively from eight referral institutions. Survival time was assessed for dogs treated with surgery alone as well as dogs who received adjunctive radiation therapy and/or chemotherapy. Median survival time in the 12 dogs treated with surgery alone was 42 days (range: 3‐1333 days). The three dogs treated with surgery and chemotherapy had a median survival time of 82 days (range: 56‐305 days). Only one dog was treated with surgery and radiation therapy; this dog survived 101 days. Six dogs were treated with surgery, radiation therapy and chemotherapy; these dogs had a median survival time of 261 days (range: 223‐653 days). Cause of death in all cases that survived the initial postoperative period was euthanasia secondary to confirmed or suspected tumor regrowth. The results of this study suggest that definitive radiation therapy, possibly combined with concurrent chemotherapy, significantly improves survival in dogs treated with palliative decompressive surgery for vertebral OSA and should be the treatment of choice in selected cases.  相似文献   

13.
Acute thoracolumbar intervertebral disc herniation in dogs is a common cause of “back” pain, pelvic limb paresis or paralysis and incontinence. Treatment of this condition has long been a source of controversy, especially since the introduction of surgical interventions in the 1950s. Unfortunately, formal clinical trials to compare efficacy of conservative and surgical interventions have never been carried out and the current lack of clinical equipoise on this subject now precludes such a trial on ethical grounds. In this article we re‐examine and discuss earlier published data on recovery associated with the various therapies, focusing on evidence suggesting that decompressive surgery and fenestration may be equally efficacious.  相似文献   

14.
The aim of this paper was to assess the effectiveness of treatment of Type I (according to Hansen) intervertebral disc extrusion using the fenestration method. The evaluated clinical material included 37 chondrodystrophic dogs in which multiple fenestration (from 2 to 6 intervertebral spaces) was performed. Dachshunds comprised 86.5% of patients. All dogs were administered corticosteroids during the operation. A mass similar to a slightly jelly-like yogurt, cottage cheese or plaster-like consistency was extracted. In one case a post-surgical pyogenic infection of the wound occured. In two cases, a deterioration in the neurological state followed the fenestration procedure of the cervical spine. In one case of thoraco-lumbar spine fenestration, a deterioration of clinical state was found. Recovery was observed after disc extrusion from the cervical spine in 8 out of 11 dogs, from the thoraco-lumbar spine in 12 out of 14 dogs with the 2nd grade clinical signs and in 11 out of 12 dogs with the 3rd grade clinical sings. In 6 dogs, recurrence of first or second grade clinical signs occurred, but only half of them had to undergo treatment. The probability of dog recovery did not depend on the degree of symptom intensity in a statistically significant way (p=0.11) or on the duration of the disease before the surgical treatment (p=0.87).  相似文献   

15.
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   

16.
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   

17.
Thoracolumbar disc extrusions were diagnosed in three chondrodystrophic dogs with paraparesis of up to three days duration. All cases were managed by hemilaminectomy and removal of extruded disc material. In one dog, fenestration of the herniated disc space was also performed. Initially neurological function improved or was unchanged, but from two to ten days postoperatively clinical signs of deterioration became apparent. In all the dogs, recurrence of disc extrusion at the same location as the initial extrusion was diagnosed by computer tomography and at a second surgery abundant disc material was found at the hemilaminectomy site between the dura and an implanted graft of autogenous fat.  相似文献   

18.
Neurological improvement after decompressive surgery, without routine therapeutic or prophylactic disc fenestration, was evaluated retrospectively in a consecutive series of 93 dachshunds with thoracolumbar disc extrusion. In 24 per cent of procedures, deep pain sensation was not elicited in at least one hind paw before surgery. Median neurological status one to seven days after surgery, at the time of discharge, was significantly improved after hemilaminectomy compared with dorsal laminectomy (P < 0·05). After hemilaminectomy, deep pain sensation was not elicited in one or both hind paws of 8 per cent of dogs in which pain sensation was elicited before surgery, compared with 21 per cent after dorsal laminectomy (P > 0·05). Improvement in neurological grade at follow-up examination two to 12 weeks after hemilaminectomy was not significantly different compared with dorsal laminectomy (P > 0·05). Of dogs which were unable to walk before surgery, 83 per cent regained the ability to walk after hemilaminectomy, compared with 74 per cent after dorsal laminectomy (P > 0·05). In both groups, 50 per cent of dogs in which deep pain sensation was abnormal before surgery eventually regained the ability to walk after surgery (P = 1). One to two years after the first operation, a second laminectomy was performed in only 5 per cent of dogs because of extrusion of a different intervertebral disc which had not been fenestrated.  相似文献   

19.
The accuracy of survey radiographs in the diagnosis of acute thoracolumbar disc disease in 36 Dachshunds was determined by comparison with lumbar myelographic findings using iohexol. The value of making radiographs immediately after injection of contrast medium and the effectiveness of oblique radiographs in determining the exact circumferential distribution of extruding or protruding disc material were assessed. The presence of a double contrast medium column, resistance to injection and the presence of cerebrospinal fluid flow during needle placement was also evaluated. The location of the affected disc was accurately determined on survey radiographs in only 26 dogs. The myelographic technique used in this study resulted in the correct intervertebral space being identified, together with the exact circumferential distribution of disc material, in 35 dogs. Survey radiographs alone are inadequate for localization of protruding or extruding disc material.  相似文献   

20.
Endoscopy was used to determine the prevalence of subclinical gastroduodenal ulceration in 30 Dachshunds undergoing decompressive surgery for acute intervertebral disc prolapse. The endoscopy was performed on the day of admission and on the 3rd or 4th day after surgery. Three regions of the stomach (cardia, corpus and pylorus) and the proximal duodenum were visually inspected and biopsy samples were taken for histopathology. The combination of visual and microscopic changes were then used to determine the prevalence of subclinical gastroduodenal ulceration in this population. An overall prevalence of 76% was calculated from these findings. Ulcerogenic medication administered prior to admission did not appear to influence the prevalence. This result identifies a need for veterinarians to be aware of this potentially severe complication and warrants the use of prophylactic anti-ulcer medication in spinal surgery patients.  相似文献   

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