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导致相邻节段疾病的脊柱退变和弥漫性特发性骨肥厚(DISH)。

Spondylosis deformans and diffuse idiopathic skeletal hyperostosis (dish) resulting in adjacent segment disease.

作者信息

Ortega Maria, Gonçalves Rita, Haley Allison, Wessmann Annette, Penderis Jacques

机构信息

School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G61 1QH, UK.

出版信息

Vet Radiol Ultrasound. 2012 Mar-Apr;53(2):128-34. doi: 10.1111/j.1740-8261.2011.01891.x.

Abstract

Spondylosis deformans and diffuse idiopathic skeletal hyperostosis (DISH) are usually incidental findings and in most dogs are either asymptomatic or associated with mild clinical signs. Severe spondylosis deformans and DISH can result in complete bony fusion of consecutive vertebral segments. One of the recognised complications following vertebral fusion in human patients is the development of adjacent segment disease, which is defined as degenerative changes, most commonly degenerative intervertebral disc disease, in the mobile vertebral segment neighboring a region of complete vertebral fusion. A similar syndrome following cervical fusion in dogs has been termed the domino effect. The purpose of this retrospective study was to investigate the hypothesis that vertebral fusion occurring secondary to spondylosis deformans or DISH in dogs would protect fused intervertebral disc spaces from undergoing degeneration, but result in adjacent segment disease at neighbouring unfused intervertebral disc spaces. Eight dogs with clinical signs of thoracolumbar myelopathy, magnetic resonance imaging of the thoracolumbar vertebral column, and spondylosis deformans or DISH producing fusion of > or = 2 consecutive intervertebral disc spaces were evaluated. Vertebral fusion of > or = 2 consecutive intervertebral disc spaces was correlated (P = 0.0017) with adjacent segment disease at the neighbouring unfused intervertebral disc space. Vertebral fusion appeared to protect fused intervertebral disc spaces from undergoing degeneration (P < 0.0001). Adjacent segment disease should be considered in dogs with severe spondylosis deformans or DISH occurring in conjunction with a thoracolumbar myelopathy.

摘要

脊柱关节病和弥漫性特发性骨肥厚(DISH)通常是偶然发现,在大多数犬中要么无症状,要么伴有轻微临床症状。严重的脊柱关节病和DISH可导致连续椎体节段完全骨融合。人类患者椎体融合后公认的并发症之一是相邻节段疾病的发生,其定义为在完全椎体融合区域相邻的活动椎体节段出现退行性改变,最常见的是退行性椎间盘疾病。犬颈椎融合后出现的类似综合征被称为多米诺效应。这项回顾性研究的目的是调查以下假设:犬因脊柱关节病或DISH继发的椎体融合可保护融合的椎间盘间隙不发生退变,但会导致相邻未融合椎间盘间隙出现相邻节段疾病。对8只出现胸腰椎脊髓病临床症状、进行了胸腰椎脊柱磁共振成像且因脊柱关节病或DISH导致≥2个连续椎间盘间隙融合的犬进行了评估。≥2个连续椎间盘间隙的椎体融合与相邻未融合椎间盘间隙的相邻节段疾病相关(P = 0.0017)。椎体融合似乎可保护融合的椎间盘间隙不发生退变(P < 0.0001)。对于患有严重脊柱关节病或DISH并伴有胸腰椎脊髓病的犬,应考虑相邻节段疾病。

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