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接受背侧椎板切除术治疗的退行性腰椎管狭窄症犬的术后计算机断层扫描和低场磁共振成像结果

Postoperative computed tomography and low-field magnetic resonance imaging findings in dogs with degenerative lumbosacral stenosis treated by dorsal laminectomy.

作者信息

Rapp Martin, Ley Charles J, Hansson Kerstin, Sjöström Lennart

机构信息

Martin Rapp, Evidensia Specialistdjursjukhuset Strömsholm, Djursjukhusvägen 11, 734 94 Strömsholm, Sweden, E-mail:

出版信息

Vet Comp Orthop Traumatol. 2017 Mar 20;30(2):143-152. doi: 10.3415/VCOT-16-06-0096. Epub 2017 Jan 17.

Abstract

OBJECTIVES

To describe postoperative computed tomography (CT) and magnetic resonance imaging (MRI) findings in dogs with degenerative lumbosacral stenosis (DLSS) treated by dorsal laminectomy and partial discectomy.

METHODS

Prospective clinical case study of dogs diagnosed with and treated for DLSS. Surgical and clinical findings were described. Computed tomography and low field MRI findings pre- and postoperatively were described and graded. Clinical, CT and MRI examinations were performed four to 18 months after surgery.

RESULTS

Eleven of 13 dogs were clinically improved and two dogs had unchanged clinical status postoperatively despite imaging signs of neural compression. Vacuum phenomenon, spondylosis, sclerosis of the seventh lumbar (L7) and first sacral (S1) vertebrae endplates and lumbosacral intervertebral joint osteoarthritis became more frequent in postoperative CT images. Postoperative MRI showed mild disc extrusions in five cases, and in all cases contrast enhancing non-discal tissue was present. All cases showed contrast enhancement of the L7 spinal nerves both pre- and postoperatively and seven had contrast enhancement of the lumbosacral intervertebral joints and paraspinal tissue postoperatively. Articular process fractures or fissures were noted in four dogs.

CLINICAL SIGNIFICANCE

The study indicates that imaging signs of neural compression are common after DLSS surgery, even in dogs that have clinical improvement. Contrast enhancement of spinal nerves and soft tissues around the region of disc herniation is common both pre- and postoperatively and thus are unreliable criteria for identifying complications of the DLSS surgery.

摘要

目的

描述经后路椎板切除术和部分椎间盘切除术治疗的退行性腰椎管狭窄症(DLSS)犬术后的计算机断层扫描(CT)和磁共振成像(MRI)表现。

方法

对诊断为DLSS并接受治疗的犬进行前瞻性临床病例研究。描述手术和临床发现。描述并分级术前和术后的CT及低场MRI表现。术后4至18个月进行临床、CT和MRI检查。

结果

13只犬中有11只临床症状改善,2只犬术后临床状态未改变,尽管有神经受压的影像学表现。术后CT图像中,真空现象、骨质增生、第七腰椎(L7)和第一骶椎(S1)椎体终板硬化以及腰骶椎间关节骨关节炎更为常见。术后MRI显示5例有轻度椎间盘突出,所有病例均有非椎间盘组织的对比增强。所有病例术前和术后L7脊神经均有对比增强,7例术后腰骶椎间关节和椎旁组织有对比增强。4只犬出现关节突骨折或裂隙。

临床意义

该研究表明,即使在临床症状改善的犬中,DLSS手术后神经受压的影像学表现也很常见。椎间盘突出区域周围的脊神经和软组织术前和术后均常见对比增强,因此是识别DLSS手术并发症的不可靠标准。

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