Müller Friedrich, Schenk Henning C, Forterre Franck
Tierklink Lüneburg, Lüneburg, Germany.
Vetsuisse Faculty of Bern, Department of Clinical Veterinary Medicine, Small Animal Clinic, Bern, Switzerland.
Vet Surg. 2017 Apr;46(3):354-366. doi: 10.1111/vsu.12623. Epub 2017 Mar 17.
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).
Prospective study.
59 client-owned dogs with DLSS.
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.
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.
MTV results in clinical improvement and morphometric enlargement of the foraminal area in dogs with variable degrees of foraminal stenosis.
MTV may be a valuable minimally invasive option for treatment of dogs with DLSS.
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。
前瞻性研究。
59只患有DLSS的客户拥有的犬。
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。
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。
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。
MTV可能是治疗患有DLSS的犬的一种有价值的微创选择。