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胸腰段脊髓严重损伤犬的长期功能预后:87例(1996 - 2001年)

Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001).

作者信息

Olby Natasha, Levine Jay, Harris Tonya, Muñana Karen, Skeen Todd, Sharp Nick

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.

出版信息

J Am Vet Med Assoc. 2003 Mar 15;222(6):762-9. doi: 10.2460/javma.2003.222.762.

DOI:10.2460/javma.2003.222.762
PMID:12675299
Abstract

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.

摘要

目的

确定因椎间盘突出或外伤导致截瘫和后肢深部痛觉丧失(DPP)的犬的长期(>6个月)预后情况。

设计

回顾性研究。

动物

87只犬。

方法

将预后判定为成功或不成功。评估神经解剖定位、品种、年龄、体重、性别以及(对于椎间盘突出的犬)术前症状出现速度和截瘫持续时间与预后的相关性。通过电话联系主人以确定长期健康问题。

结果

17只外伤犬中有9只接受了治疗,2只恢复了行走能力;17只犬中无一恢复DPP。70只椎间盘突出犬中有64只接受了手术;9只(14%)在术后3周内实施了安乐死(7只因上行性脊髓软化),37只(58%)恢复了DPP和行走能力,7只(11%)恢复了行走能力但未恢复DPP,11只(17%)仍为截瘫且无DPP。预后与所评估的任何因素均无关联,但行走恢复速度与体重和年龄显著相关。恢复DPP的犬中有15只(41%)和12只(32%)分别出现间歇性大便失禁和小便失禁。

结论及临床意义

结果表明,因外伤导致无DPP的截瘫犬预后谨慎,而椎间盘突出的犬恢复运动功能的机会更大。三分之一恢复运动功能的犬有间歇性失禁。持续丧失DPP并不排除运动功能的恢复,但此类犬仍会失禁。

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