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计算机断层扫描测量微创经髂骨椎体阻滞术对犬腰骶部形态学的短期和长期影响。

Short-term and long-term effects of a minimally invasive transilial vertebral blocking procedure on the lumbosacral morphometry in dogs measured by computed tomography.

作者信息

Müller Friedrich, Schenk Henning C, Forterre Franck

机构信息

Tierklink Lüneburg, Lüneburg, Germany.

Vetsuisse Faculty of Bern, Department of Clinical Veterinary Medicine, Small Animal Clinic, Bern, Switzerland.

出版信息

Vet Surg. 2017 Apr;46(3):354-366. doi: 10.1111/vsu.12623. Epub 2017 Mar 17.

Abstract

OBJECTIVE

To determine the effects of a minimally invasive transilial vertebral (MTV) blocking procedure on the computed tomographic (CT) appearance of the lumbosacral (L7/S1) junction of dogs with degenerative lumbosacral stenosis (DLSS).

STUDY DESIGN

Prospective study.

ANIMALS

59 client-owned dogs with DLSS.

METHODS

Lumbosacral CT images were acquired with hyperextended pelvic limbs before and after MTV in all dogs. Clinical follow-up was obtained after 1 year, including a neurologic status classified in 4 grades, and if possible, CT. Morphometric measurements (Mean ± SEM) including foraminal area, endplate distance at L7/S1 and LS angle were obtained on sets of reformatted parasagittal and sagittal CT images.

RESULTS

The mean foraminal area (ForL) increased from 32.5 ± 1.7 mm to 59.7 ± 1.9 mm on the left and from 31.1 ± 1.4 mm to 59.1 ± 2.0 mm on the right (ForR) side after MTV. The mean endplate distance (EDmd) between L7/S1 increased from 3.7 ± 0.1 mm to 6.0 ± 0.1 mm, and mean lumbosacral angle (LSa) from 148.0 ± 1.1° to 170.0 ± 1.1° after MTV. CT measurements were available 1 year postoperatively in 12 cases: ForL: 41.2 ± 3.1 mm ; ForR: 37.9 ± 3.1 mm ; EDmd: 4.3 ± 0.4 mm, and LSa 157.6 ± 2.1° (values are mean and standard error of mean =  SEM). All 39 dogs with long-term follow-up improved by at least 1 neurologic grade, 9/39 improving by 3 grades, 15/39 by 2 grades, and 15/39 by 1 grade.

CONCLUSIONS

MTV results in clinical improvement and morphometric enlargement of the foraminal area in dogs with variable degrees of foraminal stenosis.

CLINICAL RELEVANCE

MTV may be a valuable minimally invasive option for treatment of dogs with DLSS.

摘要

目的

确定微创经髂骨椎体(MTV)阻滞术对患有退行性腰骶部狭窄(DLSS)的犬腰骶(L7/S1)关节计算机断层扫描(CT)表现的影响。

研究设计

前瞻性研究。

动物

59只患有DLSS的客户拥有的犬。

方法

在所有犬接受MTV手术前后,在骨盆肢体过伸位采集腰骶部CT图像。术后1年进行临床随访,包括将神经状态分为4个等级,并尽可能进行CT检查。在一组重新格式化的矢状旁位和矢状CT图像上获得形态学测量值(平均值±标准误),包括椎间孔面积、L7/S1处终板距离和腰骶角。

结果

MTV术后,左侧椎间孔平均面积(ForL)从32.5±1.7mm增加到59.7±1.9mm,右侧(ForR)从31.1±1.4mm增加到59.1±2.0mm。MTV术后,L7/S1之间的平均终板距离(EDmd)从3.7±0.1mm增加到6.0±0.1mm,平均腰骶角(LSa)从148.0±1.1°增加到170.0±1.1°。术后1年有12例可获得CT测量值:ForL:41.2±3.1mm;ForR:37.9±3.1mm;EDmd:4.3±0.4mm,LSa 157.6±2.1°(数值为平均值和平均标准误=SEM)。所有39只接受长期随访的犬神经状态至少改善1个等级,其中9/39改善3个等级,15/39改善2个等级,15/39改善1个等级。

结论

MTV可使不同程度椎间孔狭窄的犬临床症状改善,椎间孔面积形态学增大。

临床意义

MTV可能是治疗患有DLSS的犬的一种有价值的微创选择。

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