Downes C J, Gemmill T J, Gibbons S E, McKee W M
Willows Referral Service, Shirley, Solihull, West Midlands B90 4NH, UK.
J Small Anim Pract. 2009 Oct;50(10):525-35. doi: 10.1111/j.1748-5827.2009.00808.x.
To evaluate the results of hemilaminectomy and vertebral stabilisation (+/- annulectomy) for the treatment of thoracolumbar disc protrusion.
The medical records of dogs with thoracolumbar annular protrusions treated by hemilaminectomy and vertebral stabilisation were reviewed. Neurological function was assessed 24 hours following surgery. Long-term follow-up was by clinical examination or telephone questionnaire.
Twenty-eight dogs fulfilled the criteria. Age ranged from 4 to 12.5 years (median 8 years, mean 7.7 years), bodyweight from 5.1 to 51.5 kg (median 28 kg, mean 27.1 kg), and duration of neurological signs before presentation from 48 hours to 104 weeks (median 5 weeks, mean 9.3 weeks). At presentation 22 dogs were ambulatory and six were non-ambulatory. Myelography and/or magnetic resonance imaging (MRI) identified 31 thoracolumbar protrusions causing spinal cord compression. Unilateral hemilaminectomy was performed in 27 dogs and bilateral hemilaminectomy in one dog. Partial annulectomy was performed in 24 of 31 protrusions. Stabilisation was performed using vertebral body bone plates in 26 dogs and vertebral body screws and bone cement in two dogs. Internal vertebral venous plexus haemorrhage was recorded in nine dogs. A screw was inadvertently placed into an intervertebral disc in two dogs. Neurological examination 24 hours postoperatively revealed deterioration in pelvic limb motor function in 17 dogs. One dog was euthanatised at the owner's request 6 days after surgery. Long-term evaluation of 24 cases was performed 3 to 52 months following surgery (median 21 months, mean 23.9 months). Six dogs had improved from their preoperative status and one had deteriorated as assessed by the authors. Fifteen dogs had improved from their preoperative status and two were unchanged as assessed by owners.
Hemilaminectomy and vertebral stabilisation are an effective treatment for chronic spinal cord compression due to thoracolumbar annular protrusion in dogs. A temporary deterioration in neurological function is not uncommon following surgery. Internal vertebral plexus haemorrhage and inappropriate vertebral body screw placement are potential complications.
评估半椎板切除术和椎体稳定术（±椎间盘切除术）治疗胸腰椎间盘突出症的效果。
回顾接受半椎板切除术和椎体稳定术治疗的胸腰椎间盘突出症犬的病历。术后24小时评估神经功能。通过临床检查或电话问卷进行长期随访。
28只犬符合标准。年龄范围为4至12.5岁（中位数8岁，平均7.7岁），体重为5.1至51.5千克（中位数28千克，平均27.1千克），就诊前神经症状持续时间为48小时至104周（中位数5周，平均9.3周）。就诊时，22只犬可自主行走，6只不能自主行走。脊髓造影和/或磁共振成像（MRI）发现31处胸腰椎间盘突出导致脊髓受压。27只犬行单侧半椎板切除术，1只犬行双侧半椎板切除术。31处突出中的24处进行了部分椎间盘切除术。26只犬使用椎体骨板进行稳定术，2只犬使用椎体螺钉和骨水泥进行稳定术。9只犬记录到椎内静脉丛出血。2只犬的螺钉不慎置入椎间盘。术后24小时神经检查发现17只犬盆腔肢体运动功能恶化。1只犬术后6天应主人要求实施安乐死。对24例进行了术后3至52个月的长期评估（中位数21个月，平均23.9个月）。作者评估6只犬较术前状态有所改善，1只恶化。主人评估15只犬较术前状态有所改善，2只无变化。
半椎板切除术和椎体稳定术是治疗犬胸腰椎间盘突出所致慢性脊髓压迫的有效方法。术后神经功能暂时恶化并不罕见。椎内静脉丛出血和椎体螺钉置入不当是潜在并发症。
