Hettlich Bianca F, Kerwin Sharon C, Levine Jonathan M
Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TX, USA.
Vet Surg. 2012 Feb;41(2):215-20. doi: 10.1111/j.1532-950X.2011.00920.x. Epub 2011 Nov 21.
To report findings and outcomes of dogs with reherniation of nuclear material within 7 days of hemilaminectomy for acute thoracolumbar (TL) intervertebral disk extrusion.
Retrospective case series.
Chondrodystrophic dogs (n = 11).
Dogs with acute neurologic decline within 1 week of surgical decompression for TL disk extrusion were identified. Advanced imaging was used to document extradural spinal cord compression at the previous surgery site. Ten dogs had a 2nd decompressive surgery to remove extruded nuclear material.
All dogs had acute neurologic deterioration (average, 2 neurologic grades) 2-7 days after initial hemilaminectomy. Computed tomography (CT; n = 10) or myelography (n = 1) documented extradural spinal cord compression compatible with extruded disk material at the previous hemilaminectomy site. Dogs that had a 2nd surgical decompression improved neurologically within 24 hours and were paraparetic at discharge. The single dog that did not have decompressive surgery did not regain deep nociception during 185-day follow-up.
Early reherniation at the site of previous hemilaminectomy can produce acute deterioration of neurologic function and should be investigated with diagnostic imaging. Repeat decompressive surgery can lead to functional recovery.
报告急性胸腰椎（TL）椎间盘突出症半椎板切除术后7天内核物质再突出犬的检查结果和预后情况。
回顾性病例系列研究。
软骨发育不良犬（n = 11）。
确定在TL椎间盘突出症手术减压后1周内出现急性神经功能衰退的犬。采用高级影像学检查记录上次手术部位硬膜外脊髓受压情况。10只犬接受了第二次减压手术以清除突出的核物质。
所有犬在初次半椎板切除术后2 - 7天均出现急性神经功能恶化（平均2个神经功能等级）。计算机断层扫描（CT；n = 10）或脊髓造影（n = 1）记录到上次半椎板切除部位硬膜外脊髓受压，与突出的椎间盘物质相符。接受第二次手术减压的犬在24小时内神经功能改善，出院时为双后肢轻瘫。未接受减压手术的唯一一只犬在185天的随访期间未恢复深部痛觉。
先前半椎板切除部位的早期再突出可导致神经功能急性恶化，应通过诊断性影像学检查进行评估。重复减压手术可实现功能恢复。
