Ferrand François-Xavier, Moissonnier Pierre, Filleur Aurélie, Cachon Thibaut, Fau Didier, Viguier Eric, Carozzo Claude
Department of Small Animal Surgery, VetAgro Sup, Campus Vétérinaire de Lyon, Université de Lyon, Marcy L'Etoile, France.
Department of Surgery, Veterinary Teaching Hospital, Veterinary School of Maisons Alfort, 94704 Maisons Alfort cedex, France.
Ir Vet J. 2015 Dec 1;68:27. doi: 10.1186/s13620-015-0056-z. eCollection 2015.
The purpose of this retrospective study was to assess short-and medium-term outcomes in dogs with chronic ventral thoracolumbar intervertebral disc disease (IVDD) treated by thoracolumbar partial lateral corpectomy (TLPLC). Dogs surgically treated for chronic ventral IVDD by TLPLC were included. For each dog, neurological status evolution and complications were reported. Factors that could have influenced neurological recovery were statistically tested.
A total of 107 dogs were included in the study. Before surgery, 67.3 % of the dogs were able to walk, 24.3 % were grade 3, and 8.4 % were grade 4. The median hospitalization time was 3 days, and 82.2 % of the dogs were able to walk at discharge. The medium-term neurological grade was reached at a median time of 2 months. At the medium-term follow-up (median 12 months), 74.3 % of the dogs were neurologically improved, 22.9 % were stable, and 2.8 % were worsened. A total of 91.4 % of dogs were ambulatory, with 58.6 % of dogs having a normal gait. Preoperative neurological grade was significantly associated with the neurological status 24 h after the surgery and at discharge. Dogs with a higher preoperative neurological grade had a better chance of improving but lower odds of walking at 24 h after the surgery and at discharge compared with dogs with a lower preoperative grade. Spinal compression recurrence at the same surgical site was confirmed in 8 cases.
Even if TLPLC leads to several intra and postoperative complications, this technique is a viable surgical option to treat chronic ventral IVDD.
本回顾性研究的目的是评估经胸腰椎部分侧方椎体切除术(TLPLC)治疗的慢性胸腰椎腹侧椎间盘疾病(IVDD)犬的短期和中期预后。纳入接受TLPLC手术治疗慢性腹侧IVDD的犬。记录每只犬的神经状态演变和并发症情况。对可能影响神经恢复的因素进行统计学检验。
本研究共纳入107只犬。术前,67.3%的犬能够行走,24.3%为3级,8.4%为4级。中位住院时间为3天,82.2%的犬出院时能够行走。中期神经分级在中位时间2个月时达到。在中期随访(中位12个月)时,74.3%的犬神经功能改善,22.9%稳定,2.8%恶化。共有91.4%的犬可自主活动,其中58.6%的犬步态正常。术前神经分级与术后24小时及出院时的神经状态显著相关。与术前神经分级较低的犬相比,术前神经分级较高的犬改善的机会更大,但术后24小时及出院时行走的几率较低。8例在同一手术部位证实有脊髓压迫复发。
即使TLPLC会导致一些术中及术后并发症,但该技术仍是治疗慢性腹侧IVDD的一种可行的手术选择。