Wyatt Sophie, Gonçalves Rita, Gutierrez-Quintana Rodrigo, De Decker Steven
J Am Vet Med Assoc. 2018 Sep 15;253(6):768-773. doi: 10.2460/javma.253.6.768.
OBJECTIVE To characterize outcomes following nonsurgical treatment of congenital thoracic vertebral body malformations causing neurologic deficits in dogs. DESIGN Retrospective case series. ANIMALS 13 client-owned dogs treated nonsurgically for congenital thoracic vertebral body malformations at 3 veterinary referral hospitals from June 2009 through May 2016. PROCEDURES Data were extracted from the medical records regarding dog signalment, duration and type of clinical signs before referral, general physical and neurologic examination findings, radiographic and MRI findings, and treatments provided after diagnosis. Follow-up data were obtained from records of recheck examinations and via a standardized owner questionnaire. RESULTS All included dogs were screw-tail brachycephalic breeds with a median age of 6 months. All dogs had ambulatory paraparesis and ataxia, and in 1 dog, signs of spinal hyperesthesia could be elicited. Nonsurgical treatments consisted of restricted exercise without (n = 5) or with (3) physiotherapy, physiotherapy without restricted exercise (3), and no exercise modification (2). Seven dogs received additional nonsurgical treatment consisting of prednisolone (n = 5) or gabapentin (2). Four dogs were eventually euthanized because of progressive neurologic deterioration, 2 underwent surgery for the same reason, and the remaining 7 dogs survived for ≥ 170 days after diagnosis, despite progressive neurologic deterioration. CONCLUSIONS AND CLINICAL RELEVANCE Nonsurgical treatment of congenital thoracic vertebral body malformations was associated with an unfavorable outcome in this group of dogs. Despite this treatment, all dogs had progression of clinical signs.
目的 描述非手术治疗引起犬神经功能缺损的先天性胸椎椎体畸形后的预后情况。 设计 回顾性病例系列。 动物 2009年6月至2016年5月期间，在3家兽医转诊医院接受非手术治疗先天性胸椎椎体畸形的13只客户拥有的犬。 程序 从医疗记录中提取有关犬的品种特征、转诊前临床症状的持续时间和类型、一般体格检查和神经学检查结果、放射学和MRI检查结果以及诊断后提供的治疗方法的数据。通过复查记录和标准化的主人问卷获得随访数据。 结果 所有纳入的犬均为短尾短头品种，中位年龄为6个月。所有犬均有行走性轻瘫和共济失调，1只犬可引出脊髓感觉过敏体征。非手术治疗包括无（n = 5）或有（n = 3）物理治疗的限制运动、无限制运动的物理治疗（n = 3）以及无运动调整（n = 2）。7只犬接受了额外的非手术治疗（泼尼松龙，n = 5；加巴喷丁，n = 2）。4只犬因神经功能进行性恶化最终实施安乐死，2只犬因同样原因接受了手术，其余7只犬尽管神经功能进行性恶化，但在诊断后存活≥170天。 结论及临床意义 在这组犬中，先天性胸椎椎体畸形的非手术治疗与不良预后相关。尽管进行了这种治疗，所有犬的临床症状仍有进展。
