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采用外侧入路对20只患有退行性腰骶部狭窄的犬进行腰骶部椎间孔狭窄的手术治疗。

Surgical treatment of lumbosacral foraminal stenosis using a lateral approach in twenty dogs with degenerative lumbosacral stenosis.

作者信息

Gödde Thomas, Steffen Frank

机构信息

Tierärztliche Gemeinschaftspraxis, Piding, Germany.

出版信息

Vet Surg. 2007 Oct;36(7):705-13. doi: 10.1111/j.1532-950X.2007.00324.x.

Abstract

OBJECTIVES

To describe clinical signs, magnetic resonance imaging (MRI) and surgical findings using a lateral approach to the lumbosacral intervertebral foramen and to evaluate clinical outcomes in dogs with or without concurrent dorsal decompression and annulectomy.

STUDY DESIGN

Retrospective study.

ANIMALS

Dogs (n=20) with degenerative lumbosacral stenosis (DLSS).

METHODS

Medical records (2002-2006) of dogs that had lumbosacral lateral foraminotomy alone or in combination with dorsal decompression were reviewed. Degree of dysfunction was assessed separately for each pelvic limb; dogs with unilateral signs were included in group A, those with bilateral signs in group B. Retrieved data were: signalment, history, neurologic status on admission, 3 days, 6 weeks, and 6 months postoperatively, duration of clinical signs, results of MRI, surgical site(s), intraoperative findings, and outcome.

RESULTS

Based on the clinical and MRI findings unilateral foraminotomy was performed in 8 dogs, bilateral foraminotomy in 1 dog, unilateral foraminotomy with concurrent dorsal decompression in 7 dogs, and bilateral foraminotomy with concomitant dorsal decompression in 4 dogs. Surgery confirmed the presence of foraminal stenosis in all dogs, with osteophyte formation and soft tissue proliferations being the most common lesions. Outcome was good to excellent in 19 dogs and poor in 1 dog. Mean follow-up was 15.2 months (range, 6-42 months).

CONCLUSION

Lateral foraminotomy addresses compressive lesions within exit and middle zones of the lumbosacral foramen.

CLINICAL RELEVANCE

Successful surgical management of DLSS is dependent on recognition and correction of each of the compressive lesions within the lumbosacral junction.

摘要

目的

描述采用腰椎骶骨椎间孔外侧入路的临床体征、磁共振成像(MRI)及手术所见,并评估行或未行同期背侧减压和椎间盘切除术的犬只的临床结局。

研究设计

回顾性研究。

动物

患有退行性腰椎骶骨狭窄(DLSS)的犬只(n = 20)。

方法

回顾2002年至2006年间单独接受腰椎骶骨外侧椎间孔切开术或联合背侧减压术的犬只的病历。分别评估每个后肢的功能障碍程度;单侧体征的犬只纳入A组,双侧体征的犬只纳入B组。收集的数据包括:特征、病史、入院时及术后3天、6周和6个月的神经学状态、临床体征持续时间、MRI结果、手术部位、术中所见及结局。

结果

根据临床和MRI结果,8只犬行单侧椎间孔切开术,1只犬行双侧椎间孔切开术,7只犬行单侧椎间孔切开术并同期背侧减压,4只犬行双侧椎间孔切开术并同期背侧减压。手术证实所有犬均存在椎间孔狭窄,骨赘形成和软组织增生是最常见的病变。19只犬的结局为良好至优秀,1只犬的结局较差。平均随访时间为15.2个月(范围6 - 42个月)。

结论

外侧椎间孔切开术可处理腰椎骶骨椎间孔出口和中间区域的压迫性病变。

临床意义

成功手术治疗DLSS取决于识别和纠正腰骶部交界处的每个压迫性病变。

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