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51只犬胸腰椎部分侧方椎体切除术:槽形态测量及脊髓减压评估

Partial lateral corpectomy of the thoracolumbar spine in 51 dogs: assessment of slot morphometry and spinal cord decompression.

作者信息

Flegel Thomas, Boettcher Irene Christine, Ludewig Eberhard, Kiefer Ingmar, Oechtering Gerhard, Böttcher Peter

机构信息

Department of Small Animal Medicine, University of Leipzig, Leipzig, Germany.

出版信息

Vet Surg. 2011 Jan;40(1):14-21. doi: 10.1111/j.1532-950X.2010.00747.x. Epub 2010 Nov 15.

DOI:10.1111/j.1532-950X.2010.00747.x
PMID:21077918
Abstract

OBJECTIVE

To report slot morphometry, degree of spinal decompression, and factors influencing decompression after partial lateral corpectomy (PLC) of the thoracolumbar spine in dogs with intervertebral disc disease.

STUDY DESIGN

Case series.

ANIMALS

Dogs (n=51) with predominantly ventrally located spinal cord compression.

METHODS

PLC (n=60) were performed. Spinal cord compression was determined by computed tomographic (CT) myelography (n=46), myelography (n=2) or magnetic resonance imaging (n=3). Postsurgical CT images were used to evaluate slot dimensions and orientation, and spinal cord decompression. The influence of age, body weight, breed, breed type (chondrodystrophic, nonchondrodystrophic), disc location, lateralization and mineralization, presurgical compression, slot morphometry, and surgeon on degree of decompression were evaluated.

RESULTS

Mean slot depth was 64.1% of vertebral body width; mean height, 43.0% of vertebral body height; mean cranial extension, 29.5%; median caudal extension, 22.0% vertebral body length; mean angulation from horizontal, 6.3°. Decompression was satisfactory in 90% of sites after PLC (58% complete, 32% good). None of the analyzed factors significantly influenced decompression. All lumbar spine PLC resulted in complete or good decompression compared with 83% after thoracic PLC (P=.052). Deeper slots tended to allow more complete decompression (P=.058).

CONCLUSIONS

Thoracolumbar PLC results in satisfactory decompression in most cases with a better outcome in the lumbar spine than the thoracic spine. Achieving a slot depth equal to 2/3 of vertebral body width might facilitate complete decompression.

摘要

目的

报告患有椎间盘疾病的犬胸腰椎部分侧方椎体切除术(PLC)后的椎间隙形态测量、脊髓减压程度及影响减压的因素。

研究设计

病例系列研究。

动物

主要为脊髓腹侧受压的犬(n = 51)。

方法

实施了60例PLC手术。通过计算机断层扫描(CT)脊髓造影(n = 46)、脊髓造影(n = 2)或磁共振成像(n = 3)确定脊髓受压情况。术后CT图像用于评估椎间隙尺寸和方向以及脊髓减压情况。评估了年龄、体重、品种、品种类型(软骨发育不良型、非软骨发育不良型)、椎间盘位置、侧方化和矿化、术前压迫、椎间隙形态测量以及外科医生对减压程度的影响。

结果

平均椎间隙深度为椎体宽度的64.1%;平均高度为椎体高度的43.0%;平均头侧延伸为29.5%;尾侧延伸中位数为椎体长度的22.0%;与水平方向的平均成角为6.3°。PLC术后90%的部位减压效果满意(58%完全减压,32%良好减压)。分析的所有因素均未对减压产生显著影响。与胸段PLC术后83%的完全或良好减压相比,所有腰段PLC均导致完全或良好减压(P = 0.052)。更深的椎间隙往往能实现更完全的减压(P = 0.058)。

结论

胸腰椎PLC在大多数情况下能实现满意的减压,腰椎的效果优于胸椎。使椎间隙深度达到椎体宽度的2/3可能有助于实现完全减压。

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