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椎间盘突出部位开窗联合半椎板切除术对软骨发育不良型胸腰椎间盘疾病犬复发的影响:一项前瞻性MRI研究

Influence of intervertebral disc fenestration at the herniation site in association with hemilaminectomy on recurrence in chondrodystrophic dogs with thoracolumbar disc disease: a prospective MRI study.

作者信息

Forterre Franck, Konar Martin, Spreng David, Jaggy Andre, Lang Johann

机构信息

Department of Surgery, Radiology and Neurology, Small Animal Clinic, University of Berne, Berne, Switzerland.

出版信息

Vet Surg. 2008 Jun;37(4):399-405. doi: 10.1111/j.1532-950X.2008.00394.x.

DOI:10.1111/j.1532-950X.2008.00394.x
PMID:18564265
Abstract

OBJECTIVE

To describe the influence of fenestration at the disc herniation site on recurrence in thoracolumbar disc disease of chondrodystrophoid dogs.

STUDY DESIGN

Prospective clinical study.

ANIMALS

Chondrodystrophic dogs (n=19).

METHODS

Dogs were divided into 2 groups: group 1 (9 dogs) had thoracolumbar disc extrusion (Hansen type I) treated by hemilaminectomy and concomitant fenestration of the affected intervertebral disc and group 2 (10 dogs) had hemilaminectomy without fenestration. All dogs had 3 magnetic resonance imaging (MRI) examinations: preoperatively, immediately postoperatively to assess removal of herniated disc material, and again 6 weeks after surgery.

RESULTS

There were 13 male and 6 female dogs; mean age, 7.1 years. Thoracolumbar disc herniation was confirmed with MRI. Immediate post surgical MRI revealed that the herniated disc removal was complete in all but 1 dog and that fenestration did not lead to complete removal of nucleus pulposus within the intervertebral disc space. On the 3rd MRI examination, none of the group 1 dogs had further disc material herniation at the fenestrated site. Six of the 10 group 2 dogs had a recurrence of herniation leading to clinical signs in 3 dogs (pain in 2 dogs, paresis in 1 dog).

CONCLUSION

In thoracolumbar disc herniation, fenestration of the affected intervertebral disc space prevents further extrusion of disc material.

CLINICAL RELEVANCE

Fenestration reduces the risk of early recurrence of disc herniation and associated postoperative complications.

摘要

目的

描述椎间盘突出部位开窗术对软骨发育不良犬胸腰椎间盘疾病复发的影响。

研究设计

前瞻性临床研究。

动物

软骨发育不良犬(n = 19)。

方法

将犬分为2组:第1组(9只犬)采用半椎板切除术及患椎间盘同期开窗术治疗胸腰椎间盘突出(汉森I型),第2组(10只犬)采用无开窗的半椎板切除术。所有犬均进行3次磁共振成像(MRI)检查:术前、术后即刻以评估突出椎间盘物质的清除情况,以及术后6周再次检查。

结果

共有13只雄性犬和6只雌性犬;平均年龄7.1岁。MRI证实存在胸腰椎间盘突出。术后即刻MRI显示,除1只犬外,所有犬的突出椎间盘均被完全清除,且开窗术并未导致椎间盘间隙内髓核完全清除。在第3次MRI检查时,第1组犬中无一例在开窗部位出现进一步的椎间盘物质突出。第2组10只犬中有6只出现突出复发,导致3只犬出现临床症状(2只犬疼痛,1只犬轻瘫)。

结论

在胸腰椎间盘突出症中,对患椎间盘间隙进行开窗可防止椎间盘物质进一步突出。

临床意义

开窗可降低椎间盘突出早期复发及相关术后并发症的风险。

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