Mackenzie Shawn D, Brisson Brigitte A, Gaitero Luis, Caswell Jeff L, Liao Penting, Sinclair Melissa, Chalmers Heather J
Department of Clinical Studies, Ontario Veterinary College, Guelph, ON, N1G2W1.
Department of Pathobiology, Ontario Veterinary College, Guelph, ON, N1G2W1.
Vet Radiol Ultrasound. 2016 Mar-Apr;57(2):180-90. doi: 10.1111/vru.12316. Epub 2015 Dec 2.
Radiopaque gelified ethanol preparation has been described as a useful agent for treatment of humans with intervertebral disc protrusion. The material is injected into the nucleus pulposus under image guidance with intention to cause the protruded disc material to recede. Because treatment options for dogs with chronic protrusions are limited, new and minimally invasive treatments are desirable. The aim of this experimental, descriptive, prospective study was to assess the feasibility and safety of percutaneous injection of gelified ethanol into the lumbosacral intervertebral disc of dogs. Lumbosacral intervertebral discs of normal dogs (n = 9) were imaged with magnetic resonance imaging and then injected with gelified ethanol using image guidance. The accuracy of gelified ethanol placement in the nucleus pulposus and presence of leakage of the injected material were documented. Postinjection computed tomography (CT) findings (n = 9), short-term (n = 9) and long-term (n = 4) follow-up magnetic resonance imaging and CT findings were compared to document the distribution of the injected preparation and identify effects on adjacent tissues. Percutaneous injection of the intervertebral disc was successful in delivering radiopaque gelified ethanol to the nucleus pulposus in all dogs. Leakage of the injected material into the vertebral canal was present in three dogs immediately following injection and in another additional dog at 1 year following injection. All dogs tolerated the injection well and had no clinical adverse reactions within the study period. Findings indicated that injection of the nucleus pulposus of healthy dogs was well tolerated, even in the presence of mild leakage of material from the intervertebral disc.
不透射线的凝胶化乙醇制剂已被描述为治疗人类椎间盘突出症的一种有用药物。该材料在影像引导下注入髓核,目的是使突出的椎间盘物质回缩。由于慢性椎间盘突出症犬的治疗选择有限,因此需要新的微创治疗方法。本实验性、描述性、前瞻性研究的目的是评估经皮向犬腰骶椎间盘注射凝胶化乙醇的可行性和安全性。对正常犬(n = 9)的腰骶椎间盘进行磁共振成像,然后在影像引导下注射凝胶化乙醇。记录凝胶化乙醇在髓核中的放置准确性以及注射材料的渗漏情况。将注射后计算机断层扫描(CT)结果(n = 9)、短期(n = 9)和长期(n = 4)随访磁共振成像和CT结果进行比较,以记录注射制剂的分布情况并确定对相邻组织的影响。经皮椎间盘注射在所有犬中均成功地将不透射线的凝胶化乙醇输送至髓核。注射后立即有3只犬出现注射材料渗漏至椎管内,另外1只犬在注射后1年出现渗漏。所有犬对注射耐受性良好,在研究期间无临床不良反应。研究结果表明,即使存在椎间盘材料的轻度渗漏,对健康犬的髓核进行注射仍耐受性良好。