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急性胸腰椎间盘突出症非行走性犬手术减压后开始行走时间的预后指标:112例病例

Prognostic indicators for time to ambulation after surgical decompression in nonambulatory dogs with acute thoracolumbar disk extrusions: 112 cases.

作者信息

Davis Garrett J, Brown Dorothy C

机构信息

Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, USA.

出版信息

Vet Surg. 2002 Nov-Dec;31(6):513-8. doi: 10.1053/jvet.2002.36015.

Abstract

OBJECTIVES

To determine prognostic indicators for time to ambulation after surgical decompression in nonambulatory dogs with intact pain sensation and acute Hansen type-1 disk extrusions.

STUDY DESIGN

Retrospective clinical study.

ANIMALS

One-hundred twelve dogs with Hansen type-I disk extrusions that had decompressive hemilaminectomy or dorsal laminectomy.

METHODS

All dogs had thoracolumbar disk extrusion and were nonambulatory with intact pain sensation at admission. Variables considered included age, weight, voluntary motor function at time of anesthetic induction, glucocorticoid use, times from onset of nonambulatory status to admission and surgical decompression, time in hospital to surgical decompression, anesthetic time, surgical time, number of contrast injections required to perform a diagnostic myelogram, postoperative pain sensation, and postoperative voluntary motor function. Time to ambulation was defined as the number of days from surgical decompression until the dog was able to stand and take a series of steps without assistance.

RESULTS

One-hundred seven dogs (96%) were able to ambulate within 3 months. The mean time to ambulation was 12.9 days and was significantly shorter if dogs had postoperative voluntary motor function (7.9 days v 16.4 days, P <.0001). No other variable had a significant association with time to ambulation.

CONCLUSIONS

Few perioperative variables have prognostic value for return to ambulation. Nonambulatory dogs with intact pain sensation and Hansen type-1 disk extrusions in the thoracolumbar spine that are treated with surgical decompression have a favorable prognosis.

CLINICAL RELEVANCE

The presence of postoperative voluntary motor function is a favorable prognostic indicator for early return to ambulation.

摘要

目的

确定在无痛觉且急性汉森1型椎间盘突出的非行走性犬只进行手术减压后开始行走时间的预后指标。

研究设计

回顾性临床研究。

动物

112只患有汉森1型椎间盘突出并接受减压性半椎板切除术或背侧椎板切除术的犬只。

方法

所有犬只均有胸腰椎间盘突出,入院时为非行走性但痛觉正常。考虑的变量包括年龄、体重、麻醉诱导时的自主运动功能、糖皮质激素的使用、从非行走状态开始至入院和手术减压的时间、入院至手术减压的住院时间、麻醉时间、手术时间、进行诊断性脊髓造影所需的造影剂注射次数、术后痛觉和术后自主运动功能。开始行走时间定义为从手术减压至犬只能够在无辅助下站立并迈出一系列步伐的天数。

结果

107只犬(96%)在3个月内能够行走。平均开始行走时间为12.9天,若犬只术后有自主运动功能,则显著缩短(7.9天对16.4天,P<.0001)。没有其他变量与开始行走时间有显著关联。

结论

很少有围手术期变量对恢复行走有预后价值。接受手术减压治疗的无痛觉且胸腰椎有汉森1型椎间盘突出的非行走性犬只预后良好。

临床意义

术后自主运动功能的存在是早期恢复行走的良好预后指标。

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