Worth A J, Thompson D J, Hartman A C
Centre for Service and Working Dog Health and Research, Massey University Veterinary Teaching Hospital, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
N Z Vet J. 2009 Dec;57(6):319-30. doi: 10.1080/00480169.2009.64719.
Degenerative lumbosacral stenosis (DLSS) is characterised by intervertebral disc degeneration, with secondary bony and soft-tissue changes leading to compression of the cauda equina. Large-breed, active and working dogs are the most commonly affected by DLSS. Specific manipulative tests allow the clinician to form a high suspicion of DLSS, and initiate investigation. Changes seen using conventional radiography are unreliable, and although contrast radiography represents an improvement, advanced imaging is accepted as the diagnostic method of choice. Treatment involves decompression and/or stabilisation procedures in working dogs, although conservative management may be acceptable in pet dogs with mild signs. Prognosis for return to work is only fair, and there is a high rate of recurrence following conventional surgery. Stabilisation procedures are associated with the potential for failure of the implant, and their use has not gained universal acceptance. A new surgical procedure, dorsolateral foramenotomy, offers a potential advance in the management of DLSS. everal aspects of the pathogenesis, heritability and optimal treatment approach remain uncertain.
退行性腰骶部狭窄(DLSS)的特征是椎间盘退变,并伴有继发性骨和软组织改变,导致马尾神经受压。大型、活跃和工作犬是最常受DLSS影响的犬种。特定的手法检查可使临床医生高度怀疑DLSS,并启动调查。传统X线摄影所见的变化不可靠,尽管造影X线摄影有所改进,但先进的影像学检查被公认为首选的诊断方法。对于工作犬,治疗包括减压和/或稳定手术,不过对于症状较轻的宠物犬,保守治疗可能是可以接受的。恢复工作的预后一般,传统手术后复发率较高。稳定手术存在植入物失败的可能性,其应用尚未得到普遍认可。一种新的手术方法,即背外侧椎间孔切开术,为DLSS的治疗提供了潜在的进展。发病机制、遗传力和最佳治疗方法的几个方面仍不确定。