Aikawa Takeshi, Shimatsu Taichi, Miyazaki Yuta
From Aikawa Veterinary Medical Center, Tokyo, Japan.
J Am Anim Hosp Assoc. 2019 Mar/Apr;55(2):110-116. doi: 10.5326/JAAHA-MS-6762. Epub 2019 Jan 17.
Medical records (2004-2016) of five dogs with a thoracolumbar spinal arachnoid diverticula (SAD) that was diagnosed with stress myelography in four dogs and magnetic resonance imaging in three, and who had hemilaminectomy, diverticular marsupialization, and vertebral stabilization, were reviewed. Data on previous treatment, pre- and postoperative neurologic status, diagnostic findings, surgical techniques, and outcomes was retrieved. Follow-up clinical and radiographic evaluations were performed immediately; ∼1, 2, and 6 mo postoperatively; and at annual follow-up examinations. The stress myelography demonstrated spinal cord dynamic compression in three of four dogs and change in size or shape of the SAD in all four. Two dogs who had SAD recurrences 4 and 13 mo after previous surgical dural fenestration, and one dog with no previous SAD treatment demonstrated long-term neurological improvement after vertebral stabilization (49, 77, and 126 mo). In two other dogs, recurrence of clinical signs was observed at the follow-up (8 and 12 mo). This case series suggested that repetitive spinal cord injury from the dynamic lesion appears to be one potential cause of thoracolumbar SADs. In cases with dynamic lesions confirmed by stress myelography, vertebral stabilization with conventional techniques is indicated to prevent SAD recurrence.
回顾了5只患有胸腰段脊髓蛛网膜憩室（SAD）犬的病历（2004 - 2016年），其中4只犬通过应激脊髓造影诊断，3只通过磁共振成像诊断，所有犬均接受了半椎板切除术、憩室袋形缝合术和椎体稳定术。收集了关于既往治疗、术前和术后神经状态、诊断结果、手术技术及预后的数据。术后立即、术后约1、2和6个月以及每年的随访检查时进行了临床和影像学评估。应激脊髓造影显示，4只犬中有3只存在脊髓动态受压，4只犬的SAD大小或形状均有改变。2只犬在先前手术硬脊膜开窗术后4个月和13个月出现SAD复发，1只未接受过SAD治疗的犬在椎体稳定术后（49、77和126个月）神经功能得到长期改善。另外2只犬在随访时（8个月和12个月）出现临床症状复发。该病例系列表明，动态病变导致的重复性脊髓损伤似乎是胸腰段SAD的一个潜在原因。在经应激脊髓造影证实存在动态病变的病例中，建议采用传统技术进行椎体稳定术以预防SAD复发。
