Forterre Franck, Tomek Ales, Rytz Ulrich, Brunnberg Leo, Jaggy Andre, Spreng David
Small Animal Clinic, Department of Surgery and Neurology, University of Berne, Berne, Switzerland.
Vet Surg. 2007 Jul;36(5):464-71. doi: 10.1111/j.1532-950X.2007.00293.x.
To report clinical features associated with iatrogenic peripheral nerve injury in dogs and cats admitted (1997-2006) to a referral teaching hospital.
Retrospective study.
Dogs (n=18), 9 cats.
Patients had acute signs of monoparesis attributable to sciatic nerve dysfunction that developed after treatment. Neurologic examination and electrodiagnostic testing were performed. Surgical therapy was used for nerve entrapment and delayed reconstructive surgery used in other cases.
Of 27 nerve injuries, 25 resulted from surgery (18 with treatment of pelvic injuries). Iliosacral luxation repair resulted in tibial (4 cats) and peroneal (3 dogs) nerve dysfunction. Other causes were intramedullary pinning of femoral fractures (3), other orthopedic surgery (cemented hip prosthesis [2] and tibial plateau-leveling osteotomy [1]), and perineal herniorrhaphy [1]. Nerve injury occurred after intramuscular injection (1 cat, 1 dog). Immediate surgical treatment was removal of intramedullary nails, extruded cement, or entrapping suture. Delayed nerve transplantation was performed in 2 dogs. Within 1 year, 13 patients recovered completely, clinical improvement occurred in 7, and there was no improvement in 7. Five of the 7 dogs that did not recover had acetabular or ilium fracture.
Iatrogenic sciatic nerve injury occurred most commonly during treatment of pelvic orthopedic diseases and had a poor prognosis. Clinical variation in sciatic nerve dysfunction in dogs and cats can be explained by species anatomic differences.
Iatrogenic sciatic nerve injury leads to severely debilitating locomotor dysfunction with an uncertain prognosis for full-functional recovery.
报告1997年至2006年收治于一家转诊教学医院的犬猫医源性周围神经损伤的临床特征。
回顾性研究。
犬（n = 18），猫9只。
患者出现治疗后因坐骨神经功能障碍导致的急性单瘫体征。进行了神经学检查和电诊断测试。手术治疗用于神经卡压，其他病例采用延迟重建手术。
27例神经损伤中，25例由手术引起（18例与骨盆损伤治疗有关）。髂骶关节脱位修复导致胫神经（4只猫）和腓总神经（3只犬）功能障碍。其他原因包括股骨干骨折髓内固定（3例）、其他骨科手术（骨水泥型髋关节假体植入[2例]和胫骨平台平整截骨术[1例]）以及会阴疝修补术[1例]。神经损伤发生于肌肉注射后（1只猫，1只犬）。立即手术治疗为取出髓内钉、挤出骨水泥或去除卡压缝线。2只犬接受了延迟神经移植。1年内，13例患者完全恢复，7例有临床改善，7例无改善。7只未恢复的犬中有5只存在髋臼或髂骨骨折。
医源性坐骨神经损伤最常发生于骨盆骨科疾病治疗期间，预后不良。犬猫坐骨神经功能障碍的临床差异可由物种解剖差异解释。
医源性坐骨神经损伤导致严重的运动功能障碍，全功能恢复的预后不确定。
