Böttcher Peter, Böttcher Irene Christine, Truar Katrin, Ludewig Eberhard, Oechtering Gerhard, Flegel Thomas
Department of Small Animal Medicine, University of Leipzig, Leipzig, Germany.
Vet Surg. 2013 May;42(4):383-91. doi: 10.1111/j.1532-950X.2012.01067.x. Epub 2012 Dec 12.
To (1) evaluate pre- and postoperative cervical spinal cord compression (SCC) in the context of uncomplicated ventral slot (VS) decompression using computed tomographic (CT) myelography and (2) report reliability of a semiquantitative SCC score using CT myelography.
Prospective and retrospective, clinical pilot study.
Dogs (n = 17) with single static intervertebral disc disease.
On matched pre- and postoperative transverse CT myelographic images, degree and lateralization of extradural SCC were scored by 4 blinded independent observers, followed by consensus finding. Inter- and intraobserver variability was quantified using intraclass correlation (ICC). Nonparametric tests were performed comparing pre- and postoperative SCC, correlation with neurologic status and significance of lateralization.
Because of invisible contrast agent, only 13 dogs could be fully evaluated. After VS, SCC was significantly reduced whereas neurologic function significantly improved. Ten dogs had residual compression, not affecting neurologic long-term outcome. Only preoperative compression score and neurologic status 3-7 weeks postoperatively were inversely correlated. Lateralization of SCC preoperatively did not affect postsurgical compression scores. Interobserver ICC was 0.848 and intraobserver ICC was 0.984.
VS improves neurologic function but often fails at completely resolving extradural SCC. The proposed CT myelographic score is highly reliable, assuring consistency among and within observers.
(1)使用计算机断层扫描(CT)脊髓造影评估单纯前路开槽(VS)减压情况下术前和术后颈椎脊髓压迫(SCC)情况,(2)报告使用CT脊髓造影的半定量SCC评分的可靠性。
前瞻性和回顾性临床初步研究。
患有单一静态椎间盘疾病的犬(n = 17)。
在匹配的术前和术后横向CT脊髓造影图像上,由4名不知情的独立观察者对硬膜外SCC的程度和侧方化进行评分,随后达成共识。使用组内相关系数(ICC)对观察者间和观察者内的变异性进行量化。进行非参数检验以比较术前和术后的SCC、与神经状态的相关性以及侧方化的显著性。
由于造影剂不可见,仅13只犬能得到充分评估。VS术后,SCC显著降低,而神经功能显著改善。10只犬有残余压迫,但不影响神经长期预后。仅术前压迫评分与术后3 - 7周的神经状态呈负相关。术前SCC的侧方化不影响术后压迫评分。观察者间ICC为0.848,观察者内ICC为0.984。
VS可改善神经功能,但常常无法完全消除硬膜外SCC。所提出的CT脊髓造影评分高度可靠,确保了观察者间和观察者内的一致性。