Auger J, Dupuis J, Quesnel A, Beauregard G
Department of Clinical Sciences, Faculté de Médecine Vétérinaire, University of Montreal, Saint-Hyacinthe, Quebec, Canada.
Vet Surg. 2000 Jan-Feb;29(1):70-80. doi: 10.1111/j.1532-950x.2000.00070.x.
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.
Retrospective clinical study.
Four client-owned dogs.
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.
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).
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.
描述一种使用外骨骼固定器对患有椎间盘炎所致腰骶部不稳定的犬进行腰骶椎节段撑开和稳定的手术技术。
回顾性临床研究。
4只客户拥有的犬。
识别并查阅1994年至1997年所有诊断为椎间盘炎的犬的病历。然后专门研究4只需要手术治疗的腰骶部椎间盘炎犬。记录手术技术、临床症状、术前诊断检查、影像学检查结果以及短期和长期重新评估的结果。
共识别出12只患有椎间盘炎的犬,其中4只患有腰骶部椎间盘炎。这4只犬因对药物治疗无反应而接受了手术撑开和稳定治疗。3只犬在L7和S1之间接受了松质骨移植,该椎体节段迅速实现了椎间融合。未接受移植的犬在拆除固定器时未实现椎间融合。但这并未影响最终的临床结果。术前存在的腰骶部疼痛和神经功能缺损在手术后迅速缓解。所有犬均接受了至少4周的联合抗生素治疗。拆除固定器时所有犬临床正常,在随访期(8 - 48个月;平均27.5个月)内均持续状况良好。
由于受累间隙的活动度,腰骶部椎间盘炎可能对保守治疗反应不佳。采用撑开和稳定以实现椎间融合的手术治疗对治疗椎间盘炎所致腰骶部不稳定非常有效。