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17例患有脊髓休克和急性胸腰段脊髓疾病犬的患病率、临床表现、预后及结局

Prevalence, clinical presentation, prognosis, and outcome of 17 dogs with spinal shock and acute thoracolumbar spinal cord disease.

作者信息

Full Amanda M, Heller Heidi L Barnes, Mercier Miyu

机构信息

VCA Aurora Animal Hospital, 2600 West Galena Boulevard, Aurora, IL, 60506.

出版信息

J Vet Emerg Crit Care (San Antonio). 2016 May;26(3):412-8. doi: 10.1111/vec.12438. Epub 2015 Dec 16.

Abstract

OBJECTIVE

To describe the prevalence, signalment, clinical features, etiology, and outcome in dogs with acute thoracolumbar disease and suspected spinal shock.

DESIGN

Retrospective clinical case study (2005-2010).

SETTING

Private specialty practice.

ANIMALS

Medical records of 263 dogs with thoracolumbar spinal magnetic resonance imaging were reviewed. If decreased or absent withdrawal reflexes were present in 1 or both pelvic limbs, in the absence of a spinal lesion in the lumbosacral intumescence, dogs were diagnosed with spinal shock. Dogs with suspected or confirmed spinal neoplasia, myelomalacia, or meningomyelitis were excluded. Seventeen of 263 dogs (6%) met inclusion criteria.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Thoracic lesions were significantly more likely to result in spinal shock when compared to lumbar lesions (P = 0.03). Fibrocartilaginous embolism was the most commonly diagnosed etiology (7 of 17 dogs), and was more common in the thoracic spine compared to in the lumbar spine (P = 0.10). Six of 17 dogs (35%) were diagnosed with intervertebral disk herniation; 4 of 17 dogs (24%) with suspected acute noncompressive nucleus pulposus extrusion. Two dogs were lost to follow-up. Fourteen of 15 (93%) dogs had improved or normal reflexes by 60 days post injury.

CONCLUSIONS

Although the prevalence of spinal shock was low, it should be considered in any dog presenting with an acute history of thoracolumbar spinal injury with reduced or absent reflexes in the pelvic limbs. The presence of spinal shock should not dissuade a veterinarian from pursuing appropriate diagnostic testing and therapy for the underlying etiology.

摘要

目的

描述患有急性胸腰椎疾病并疑似脊髓休克的犬只的患病率、特征、临床特征、病因及预后情况。

设计

回顾性临床病例研究(2005 - 2010年)。

地点

私人专科诊所。

动物

对263只进行胸腰椎脊髓磁共振成像的犬只的病历进行回顾。若一侧或双侧后肢的退缩反射减弱或消失,且腰骶膨大处无脊髓病变,则诊断为脊髓休克。排除疑似或确诊患有脊髓肿瘤、脊髓软化或脑脊膜炎的犬只。263只犬中有17只(6%)符合纳入标准。

干预措施

无。

测量指标及主要结果

与腰椎病变相比,胸椎病变导致脊髓休克的可能性显著更高(P = 0.03)。纤维软骨栓塞是最常见的诊断病因(17只犬中有7只),在胸椎比在腰椎更常见(P = 0.10)。17只犬中有6只(35%)被诊断为椎间盘突出;17只犬中有4只(24%)疑似急性非压迫性髓核突出。2只犬失访。15只犬中有14只(93%)在受伤后60天时反射改善或恢复正常。

结论

虽然脊髓休克的患病率较低,但对于任何有急性胸腰椎脊髓损伤病史且后肢反射减弱或消失的犬只都应考虑这一情况。脊髓休克的存在不应阻止兽医对潜在病因进行适当的诊断检测和治疗。

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