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[犬椎间真空现象作为计算机断层扫描结果及其作为椎间盘突出症手术治疗指标的意义]

[The intervertebral vacuum phenomenon as a computed-tomographic finding in the dog and its significance as an indicator for surgical treatment of vertebral disc herniations].

作者信息

Söffler C, Karpenstein H, Kramer M

机构信息

Charlotte Söffler, Klinikum Veterinärmedizin, Klinik für Kleintiere, Chirurgie, Justus-Liebig-Universität Gießen, Frankfurter Straße 108, 35392 Gießen, E-Mail:

出版信息

Tierarztl Prax Ausg K Kleintiere Heimtiere. 2014 Apr 16;42(2):88-93.

Abstract

OBJECTIVE

The intervertebral vacuum phenomenon (VP) in the dog describes an accumulation of gas in the intervertebral disc space. It occurs primarily after vaporization of solute gases in the extracellular fluids in fissures of degenerative vertebral discs but can also arise following a sudden fall in pressure, for example, after a vertebral disc herniation. VPs are detectable using radiography, computed tomography (CT) and magnetic resonance imaging (MRI). Intervertebral VP occurrence is an indication for vertebral disc herniation. The aim of this study was to determine the frequency and localization of the VP in intervertebral disc spaces of dogs and further to correlate the incidence of intervertebral VP with vertebral disc herniation indicative for surgical treatment.

MATERIAL AND METHODS

We evaluated CT-studies of the vertebral column of dogs presented at the clinic between January 2007 and June 2012 (n = 693). In total, 529 cases fulfilled the inclusion criterion of a CT-study of the vertebral column from the first thoracic vertebra to the first sacral vertebra in the soft tissue and bone windows. The evaluation included an inter-observer comparison between observers with and without practical experience.

RESULTS

Observers with and without practical experience identified intervertebral VP in 5.7% and 6.8% of the dogs, respectively, with a mean age of 7.7 ± 2.9 years and 7.3 ± 3.1 years, respectively. More male than female dogs were affected. In total, 66.7% and 63.9% of the dogs with VP, respectively, received surgical treatment of the vertebral column. The surgical site correlated with the location of the intervertebral VP in 55.0% and 65.2% of cases, respectively.

CONCLUSION AND CLINICAL RELEVANCE

Although intervertebral VP can indicate vertebral disc degeneration and herniation, it should not be considered a unique identifier. Localization for surgery should be based on clinical symptoms and CT- and/or MRI-findings showing vertebral disc herniation or compression of the spinal cord. Practical experience is unnecessary to detect an intervertebral VP.

摘要

目的

犬的椎间盘真空现象(VP)指椎间盘间隙内气体积聚。它主要发生在退变椎间盘裂隙中细胞外液溶质气体汽化后,但也可在压力突然下降后出现,如椎间盘突出后。VP可通过X线摄影、计算机断层扫描(CT)和磁共振成像(MRI)检测到。椎间盘VP的出现是椎间盘突出的一个指征。本研究的目的是确定犬椎间盘间隙中VP的频率和定位,并进一步将椎间盘VP的发生率与提示手术治疗的椎间盘突出相关联。

材料与方法

我们评估了2007年1月至2012年6月在诊所就诊的犬的脊柱CT研究(n = 693)。共有529例符合从第一胸椎至第一骶椎在软组织和骨窗进行脊柱CT研究的纳入标准。评估包括有实践经验和无实践经验的观察者之间的观察者间比较。

结果

有实践经验和无实践经验的观察者分别在5.7%和6.8%的犬中发现了椎间盘VP,平均年龄分别为7.7±2.9岁和7.3±3.1岁。受影响的雄性犬比雌性犬多。共有66.7%和63.9%有VP的犬分别接受了脊柱手术治疗。手术部位分别在55.0%和65.2%的病例中与椎间盘VP的位置相关。

结论及临床意义

虽然椎间盘VP可提示椎间盘退变和突出,但不应将其视为唯一标识符。手术定位应基于临床症状以及显示椎间盘突出或脊髓受压的CT和/或MRI检查结果。检测椎间盘VP无需实践经验。

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