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在因自然发生的胸腰椎椎间盘突出症而接受脊柱减压手术的犬类患者中,谐波刀片与传统方法的比较。

Comparison of harmonic blade versus traditional approach in canine patients undergoing spinal decompressive surgery for naturally occurring thoracolumbar disk extrusion.

作者信息

Hettlich Bianca F, Cook Laurie, London Cheryl, Fosgate Geoffrey T

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, Ohio, United States of America.

Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.

出版信息

PLoS One. 2017 Mar 2;12(3):e0172822. doi: 10.1371/journal.pone.0172822. eCollection 2017.

Abstract

OBJECTIVES

To assess feasibility of the harmonic Osteovue blade (HOB) for use in the soft tissue approach for dogs undergoing hemilaminectomy and to compare outcomes between dogs undergoing HOB or traditional approach (TRAD).

METHODS

A prospective randomized clinical trial was performed using 20 client-owned dogs with thoracolumbar intervertebral disk extrusion requiring hemilaminectomy. Dogs were randomly assigned to HOB or TRAD. Neurologic function and pain scores were assessed pre-operatively. Intraoperative blood loss and surgical approach time as well as postoperative pain and wound healing scores were recorded. Additionally, neurologic recovery and owner perceived quality of life were recorded at day 10 and 30 postoperative.

RESULTS

There was no significant difference in sex distribution, weight, age, preoperative neurological grade and pain score, and perioperative outcome measures between groups. Intraoperative total blood loss was minimal for HOB and TRAD (median: 0 ml (range 0-9) and 2.2 ml (range 0-6.8), respectively; p = 0.165) and approach times were similar (median: 7 min (range 5-12) and 8 min (range 5-13), respectively; p = 0.315). While changes in wound healing scores were similar, changes in postoperative pain scores and neurological function were significantly improved in the HOB compared to the TRAD group. Postoperative complications in the HOB group consisted of automutilation of part of the incision and development of a small soft, non-painful subcutaneous swelling in 1 dog each.

CONCLUSIONS

The HOB is a safe and effective tool for the soft tissue approach for routine spinal surgery in dogs and is associated with decreased pain and increased neurological function post-surgery.

摘要

目的

评估谐波骨视刀片(HOB)在接受半椎板切除术的犬软组织入路中的应用可行性,并比较接受HOB或传统入路(TRAD)的犬的手术效果。

方法

对20只因胸腰椎椎间盘突出需要进行半椎板切除术的客户拥有的犬进行了一项前瞻性随机临床试验。将犬随机分为HOB组或TRAD组。术前评估神经功能和疼痛评分。记录术中失血量和手术入路时间以及术后疼痛和伤口愈合评分。此外,在术后第10天和第30天记录神经恢复情况和主人感知的生活质量。

结果

两组之间在性别分布、体重、年龄、术前神经分级和疼痛评分以及围手术期结果指标方面没有显著差异。HOB组和TRAD组术中总失血量极少(中位数:分别为0 ml(范围0 - 9)和2.2 ml(范围0 - 6.8);p = 0.165),入路时间相似(中位数:分别为7分钟(范围5 - 12)和8分钟(范围5 - 13);p = 0.315)。虽然伤口愈合评分的变化相似,但与TRAD组相比,HOB组术后疼痛评分和神经功能的改善更为显著。HOB组术后并发症包括1只犬出现部分切口自残和1只犬出现一个小的、柔软的、无痛的皮下肿胀。

结论

HOB是犬常规脊柱手术软组织入路的一种安全有效的工具,与术后疼痛减轻和神经功能改善相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64ff/5333832/61cd436a4533/pone.0172822.g001.jpg

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