De Risio Luisa, Adams Vicki, Dennis Ruth, McConnell Fraser J
Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk, England.
J Am Vet Med Assoc. 2009 Feb 15;234(4):495-504. doi: 10.2460/javma.234.4.495.
To assess associations of severity of neurologic signs (neurologic score), involvement of an intumescence, and findings of magnetic resonance imaging (MRI) with interval to recovery and outcome in dogs with presumptive acute noncompressive nucleus pulposus extrusions.
Retrospective case series.
42 dogs with presumptive acute noncompressive nucleus pulposus extrusions.
Medical records and magnetic resonance (MR) images of dogs evaluated from 2000 through 2007 were reviewed. Inclusion criteria were acute onset of nonprogressive myelopathy following trauma or strenuous exercise, MRI of the spine performed within 7 days after onset, MRI findings consistent with acute noncompressive nucleus pulposus extrusions, and complete medical records and follow-up.
Clinical neuroanatomic localization of lesions was to the C1-C5 (n = 6), C6-T2 (6), T3-L3 (28), and L4-S3 (2) spinal cord segments. Median neurologic score was 3.5. Median duration of follow-up was 804 days (range, 3 to 2,134 days) after onset of neurologic signs. Outcome was successful in 28 (67%) dogs and unsuccessful in 14 (33%) dogs. Severity of neurologic signs, extent of the intramedullary hyperintensity on sagittal and transverse T2-weighted MR images, and detection of intramedullary hypointensity on GRE images were all associated with outcome on univariate analysis. Results of multivariate analysis suggested that maximal cross-sectional area of the intramedullary hyperintensity on transverse T2-weighted MR images was the best predictor of outcome.
Clinical and MRI findings can help predict outcome in dogs with acute noncompressive nucleus pulposus extrusions.
评估具有假定急性非压迫性髓核突出的犬只的神经体征严重程度(神经评分)、脊髓肿胀累及情况以及磁共振成像(MRI)结果与恢复间隔和预后的相关性。
回顾性病例系列研究。
42只具有假定急性非压迫性髓核突出的犬只。
回顾了2000年至2007年期间评估的犬只的病历和磁共振(MR)图像。纳入标准为创伤或剧烈运动后急性非进行性脊髓病的急性发作、发病后7天内进行的脊柱MRI、与急性非压迫性髓核突出一致的MRI表现以及完整的病历和随访资料。
病变的临床神经解剖定位为颈1至颈5脊髓节段(n = 6)、颈6至胸2脊髓节段(6)、胸3至腰3脊髓节段(28)和腰4至骶3脊髓节段(2)。神经评分中位数为3.5。神经体征出现后随访时间中位数为804天(范围为3至2134天)。28只(67%)犬只预后良好,14只(33%)犬只预后不良。单因素分析显示,神经体征严重程度、矢状位和横断位T2加权MR图像上髓内高信号的范围以及GRE图像上髓内低信号的检测均与预后相关。多因素分析结果表明,横断位T2加权MR图像上髓内高信号的最大横截面积是预后的最佳预测指标。
临床和MRI表现有助于预测急性非压迫性髓核突出犬只的预后。