Crawford Abbe H, Hedley Joanna E, Lam Richard, Drożdżyńska Maja J, De Decker Steven
J Am Vet Med Assoc. 2017 Aug 1;251(3):340-344. doi: 10.2460/javma.251.3.340.
CASE DESCRIPTION A 16-month-old neutered male Continental Giant rabbit (Lepus curpaeums) was referred for evaluation of a 7-day history of acute-onset, progressive, symmetric paraparesis. CLINICAL FINDINGS On initial examination, the rabbit was nonambulatory, and results of neurologic examination were consistent with a lesion affecting the T3-L3 spinal cord segments. Thoracic radiography showed irregular widening of the left T11-12 articular process joint. Marked dorsolateral and lateral extradural spinal cord compression with contrast enhancement of the adjacent epaxial muscles was evident on MRI images of the spine. TREATMENT AND OUTCOME A left-sided T11-T12 hemilaminectomy was performed, which revealed an abnormal and hypertrophic T11-12 articular process joint and an osteolytic lesion communicating with the vertebral canal. Copious purulent material causing marked spinal cord compression was evident, and the surgical site was lavaged extensively with sterile (0.9% NaCl) saline solution. Results of aerobic, anaerobic, and enriched bacteriologic cultures of swab specimens obtained from the surgical site were negative. Histologic analysis of biopsy samples revealed chronic purulent osteomyelitis, myositis, and fasciitis with necrosis, fibrosis, and dystrophic mineralization. The rabbit was discharged 48 hours after surgery. Ten weeks after surgery, the rabbit was ambulatory with mild paraparesis. On telephone follow-up 21 months after surgery, the owners indicated that the rabbit was healthy and expressed satisfaction with the treatment and outcome. CLINICAL RELEVANCE Paraspinal abscess with vertebral canal involvement should be considered as a differential diagnosis for rabbits with clinical signs of progressive T3-L3 myelopathy. Outcome for the patient of the present report suggested that surgical treatment including decompression and debridement can result in a favorable long-term outcome.
一只16个月大已绝育的雄性大陆巨型兔(欧洲野兔)因急性起病、进行性、对称性双下肢轻瘫7天前来评估。
初次检查时,该兔无法行走,神经学检查结果与影响胸3至腰3脊髓节段的病变相符。胸部X线摄影显示左胸11 - 12关节突关节不规则增宽。脊柱磁共振成像(MRI)图像显示明显的背外侧和外侧硬膜外脊髓受压,相邻轴上肌有对比增强。
实施了左侧胸11 - 12半椎板切除术,发现胸11 - 12关节突关节异常且肥大,有一个与椎管相通的溶骨性病变。可见大量脓性物质导致明显的脊髓受压,手术部位用无菌(0.9%氯化钠)盐水溶液进行了广泛冲洗。从手术部位获取的拭子标本进行需氧、厌氧和增菌培养结果均为阴性。活检样本的组织学分析显示为慢性脓性骨髓炎、肌炎和筋膜炎,伴有坏死、纤维化和营养不良性矿化。术后48小时该兔出院。术后10周,该兔能行走,但有轻度双下肢轻瘫。术后21个月电话随访时主人表示兔子健康,对治疗和转归满意。
对于有胸3至腰3脊髓病临床症状的兔子,应考虑椎旁脓肿累及椎管作为鉴别诊断。本报告患者的转归表明,包括减压和清创的手术治疗可带来良好的长期效果。