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犬颈椎间盘突出症部位定位中牵张反射的准确性:35例(2004 - 2007年)

Accuracy of the withdrawal reflex for localization of the site of cervical disk herniation in dogs: 35 cases (2004-2007).

作者信息

Forterre Franck, Konar Martin, Tomek Ales, Doherr Markus, Howard Judith, Spreng David, Vandevelde Marc, Jaggy André

机构信息

Department of Clinical Veterinary Medicine, Division of Small Animal Surgery, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

出版信息

J Am Vet Med Assoc. 2008 Feb 15;232(4):559-63. doi: 10.2460/javma.232.4.559.

DOI:10.2460/javma.232.4.559
PMID:18279092
Abstract

OBJECTIVE

To evaluate the accuracy of neurologic examination versus magnetic resonance imaging (MRI) in localization of cervical disk herniation and evaluate the usefulness of withdrawal reflex testing in dogs.

DESIGN

Retrospective case series.

ANIMALS

35 client-owned dogs with a single-level cervical disk herniation as determined via MRI.

PROCEDURES

1 of 2 board-certified neurologists performed a complete neurologic examination in each dog. Clinical signs of a cervical lesion included evidence of neck pain and tetraparesis. The withdrawal reflex was used for neuroanatomic localization (C1-C5 or C6-T2). Agreement between results of neurologic and MRI examinations was determined.

RESULTS

Agreement between neurologic and MRI diagnoses was 65.8%. In 11 dogs in which the lesion was clinically localized to the C6-T2 segment on the basis of a decreased withdrawal reflex in the forelimbs, MRI revealed an isolated C1-C5 disk lesion. In 1 dog, in which the lesion was suspected to be at the C1-C5 level, MRI revealed a C6-T2 lesion. Cranial cervical lesions were significantly associated with an incorrect neurologic diagnosis regarding site of the lesion.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that the withdrawal reflex in dogs with cervical disk herniation is not reliable for determining the affected site and that a decreased withdrawal reflex does not always indicate a lesion from C6 to T2.

摘要

目的

评估神经学检查与磁共振成像(MRI)在颈椎间盘突出症定位中的准确性,并评估犬类牵张反射测试的效用。

设计

回顾性病例系列。

动物

35只经MRI确诊为单节段颈椎间盘突出症的客户自养犬。

步骤

两名获得专科认证的神经科医生中的一名对每只犬进行全面的神经学检查。颈椎病变的临床体征包括颈部疼痛和四肢轻瘫的证据。牵张反射用于神经解剖定位(C1-C5或C6-T2)。确定神经学检查结果与MRI检查结果之间的一致性。

结果

神经学诊断与MRI诊断之间的一致性为65.8%。在11只犬中,根据前肢牵张反射减弱临床定位病变位于C6-T2节段,但MRI显示为孤立的C1-C5椎间盘病变。在1只犬中,怀疑病变位于C1-C5水平,但MRI显示为C6-T2病变。颈椎高位病变与病变部位的神经学诊断错误显著相关。

结论及临床意义

结果表明,颈椎间盘突出症犬的牵张反射在确定受累部位方面不可靠,牵张反射减弱并不总是表明存在C6至T2节段的病变。

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