Selcer R R, Bubb W J, Walker T L
Department of Urban Practice, College of Veterinary Medicine, University of Tennessee, Knoxville 37901.
J Am Vet Med Assoc. 1991 Jun 1;198(11):1965-8.
Hospital records and radiographs of 211 dogs and cats with vertebral column fractures or luxations evaluated at the University of Tennessee Veterinary Teaching Hospital between April 1977 and September 1985 were reviewed. After neurologic examination, status of the animal was graded on a scale of 1 to 8. Decision to treat each animal either medically or surgically was based on the extent and type of injury, neurologic signs, veterinarian's experience, and owner's wishes. After treatment, neurologic status was evaluated on the aforementioned scale and differences in the outcome of treatment were determined between surgically and medically treated groups, relative to initial neurologic status and location of the fracture. Surgically treated animals had pretreatment mean (+/- SD) neurologic status (3.71 +/- 1.35) that was slightly worse (P = 0.0079) than that of medically managed cases (5.16 +/- 1.48). Animals of the surgically treated group improved significantly (P = 0.0122) more than did those of the medically treated group but after treatment, significant differences in neurologic status were not evident between surgically (6.67 +/- 1.49) and medically (7.07 +/- 1.24) treated animals. Medically treated animals required substantially longer to reach optimal neurologic status, but the average hospital stay was nearly twice as long for the surgically treated animals (13.5 days), compared with those treated medically (7.1 days). Animals with thoracic vertebral fractures had mean neurologic status that was worse than that in animals with cervical vertebral fractures (P = 0.0109). After either medical or surgical treatment, neurologic status did not differ among animals with cervical, thoracic, or lumbar vertebral fractures.(ABSTRACT TRUNCATED AT 250 WORDS)
回顾了1977年4月至1985年9月期间在田纳西大学兽医教学医院接受评估的211只患有脊柱骨折或脱位的犬猫的医院记录和X光片。经过神经学检查后，根据1至8的等级对动物的状况进行评分。对每只动物进行药物治疗或手术治疗的决定基于损伤的程度和类型、神经学体征、兽医的经验以及主人的意愿。治疗后，根据上述等级评估神经学状况，并确定手术治疗组和药物治疗组在治疗结果上的差异，相对于初始神经学状况和骨折位置。接受手术治疗的动物术前平均（±标准差）神经学状况（3.71±1.35）比接受药物治疗的病例（5.16±1.48）略差（P = 0.0079）。手术治疗组的动物比药物治疗组的动物改善更显著（P = 0.0122），但治疗后，手术治疗（6.67±1.49）和药物治疗（7.07±1.24）的动物在神经学状况上没有明显差异。药物治疗的动物达到最佳神经学状况所需的时间长得多，但手术治疗的动物平均住院时间（13.5天）几乎是药物治疗动物（7.1天）的两倍。胸椎骨折的动物平均神经学状况比颈椎骨折的动物差（P = 0.0109）。经过药物或手术治疗后，颈椎、胸椎或腰椎骨折的动物在神经学状况上没有差异。（摘要截短于250字）
