Muguet-Chanoit Audrey C, Olby Natasha J, Lim Ji-Hey, Gallagher Ryan, Niman Zachary, Dillard Stacy, Campbell James, Early Peter, Mariani Christopher L, Muñana Karen R, Freeman Courtenay, Platt Simon R, Kent Marc, Giovanella Carley, Longshore Randall C
College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
Vet Surg. 2012 Feb;41(2):200-6. doi: 10.1111/j.1532-950X.2011.00921.x. Epub 2011 Dec 8.
To determine whether changes in the cutaneous trunci muscle (CTM) reflex are an early predictor of outcome in dogs with severe acute thoracolumbar intervertebral disc extrusion (IVDE).
Multicenter prospective cohort study.
Dogs (n = 36) with acute IVDE causing paraplegia, loss of nociception in pelvic limbs and tail, and an abnormal CTM reflex postoperatively.
The caudal border of the CTM reflex was established 24 hours after surgery and at discharge, and was reported as moving cranially, caudally, or staying static. Dogs were re-evaluated at 12-20 weeks and at 7-36 months postoperatively. Outcome was classified as improved or unimproved, successful or unsuccessful, and ascending myelomalacia or not, and compared with early movement of the CTM reflex by construction of contingency tables and performing a Fisher's exact test.
By discharge (mean, 4.7 days; SD = 2.10), CTM reflex progression was caudal in 19 dogs, static in 11, and cranial in 6. Five of 6 dogs with cranial movement developed ascending myelomalacia (P < .0001). Seventeen of 19 dogs with caudal movement showed an improvement by 12-20 weeks (P = .0046) and none developed ascending myelomalacia (P = .0013).
Postoperative changes of the caudal border of the CTM reflex are an early indicator of outcome in dogs with severe acute IVDE. Cranial movement of the CTM reflex is significantly associated with the development of ascending myelomalacia. Caudal movement is significantly associated with improvement, but not associated with a long-term successful outcome.
确定躯干皮肌(CTM)反射的变化是否是严重急性胸腰椎椎间盘突出症(IVDE)犬预后的早期预测指标。
多中心前瞻性队列研究。
患有急性IVDE导致截瘫、骨盆肢体和尾巴痛觉丧失且术后CTM反射异常的犬(n = 36)。
在术后24小时和出院时确定CTM反射的尾侧边界,并报告为向头侧、尾侧移动或保持静止。在术后12 - 20周和7 - 36个月对犬进行重新评估。将预后分为改善或未改善、成功或不成功以及是否发生上行性脊髓软化,并通过构建列联表和进行Fisher精确检验与CTM反射的早期移动情况进行比较。
到出院时(平均4.7天;标准差 = 2.10),19只犬的CTM反射进展为尾侧,11只静止,6只头侧。6只头侧移动的犬中有5只发生了上行性脊髓软化(P <.0001)。19只尾侧移动的犬中有17只在12 - 20周时显示改善(P =.0046),且无一发生上行性脊髓软化(P =.0013)。
CTM反射尾侧边界的术后变化是严重急性IVDE犬预后的早期指标。CTM反射的头侧移动与上行性脊髓软化的发生显著相关。尾侧移动与改善显著相关,但与长期成功预后无关。