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马棘间韧带切断术治疗棘突撞击和重叠致背部棘突问题后恢复运动功能的长期预后:71例(2012 - 2017年)

Long-term prognosis for return to athletic function after interspinous ligament desmotomy for treatment of impinging and overriding dorsal spinous processes in horses: 71 cases (2012-2017).

作者信息

Prisk Amanda J, García-López José M

机构信息

Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts.

出版信息

Vet Surg. 2019 Oct;48(7):1278-1286. doi: 10.1111/vsu.13298. Epub 2019 Jul 22.

DOI:10.1111/vsu.13298
PMID:31332823
Abstract

OBJECTIVE

To determine the long-term return to performance of horses with impinging and/or overriding dorsal spinous processes (ORDSP) treated with interspinous ligament desmotomy (ISLD) and to determine the prognostic value of radiographic and scintigraphic grades.

STUDY DESIGN

Retrospective study.

ANIMALS

Seventy-one horses with ORDSP treated with ISLD.

METHODS

Medical records were reviewed for signalment, physical examination, gait evaluation, and number of interspinous spaces treated. Preoperative radiographic and scintigraphic images were evaluated with grading scales. Follow-up was obtained with a telephone questionnaire. Prognostic value of the number of affected interspinous spaces, radiographic grading, and scintigraphic grading was tested by using a χ test.

RESULTS

A median follow-up of 35 months (range, 8-64) was available for 56 horses. Fifty-one of 56 (91.1%) horses returned to some level of performance, with 27 of 51 (52.9%) horses achieving equivalent or higher level of performance. Achieving a lower level of performance was attributed to recurrent back pain in nine of 24 (37.5%) horses and to unassociated lameness in nine of 24 (37.5%) horses. Owners of 44 of 56 (78.6%) horses were satisfied with the postoperative performance level, and owners of 46 of 56 (82.1%) horses would recommend the procedure. None of the variables tested influenced the return to performance.

CONCLUSION

Interspinous ligament desmotomy allowed horses with ORDSP to return to some level of performance, although fewer returned to an equivalent or higher level of performance than had previously been reported.

CLINICAL SIGNIFICANCE

Interspinous ligament desmotomy allows affected horses to return to some level of performance, regardless of the severity of radiographic and scintigraphic findings.

摘要

目的

确定接受棘间韧带切断术(ISLD)治疗的患有撞击性和/或上顶性背侧棘突(ORDSP)的马匹的长期运动恢复情况,并确定放射学和闪烁扫描分级的预后价值。

研究设计

回顾性研究。

动物

71匹接受ISLD治疗的ORDSP马匹。

方法

查阅病历,了解信号、体格检查、步态评估以及接受治疗的棘间间隙数量。术前放射学和闪烁扫描图像采用分级量表进行评估。通过电话问卷进行随访。采用χ检验来检验受影响的棘间间隙数量、放射学分级和闪烁扫描分级的预后价值。

结果

56匹马的中位随访时间为35个月(范围8 - 64个月)。56匹马中有51匹(91.1%)恢复到了一定程度的运动水平,其中51匹中的27匹(52.9%)达到了同等或更高的运动水平。运动水平较低归因于24匹马中有9匹(37.5%)出现复发性背痛,以及24匹马中有9匹(37.5%)出现无关的跛行。56匹马中有44匹(78.6%)的主人对术后运动水平满意,56匹马中有46匹(82.1%)的主人会推荐该手术。所测试的变量均未影响运动恢复情况。

结论

棘间韧带切断术使患有ORDSP的马匹恢复到了一定程度的运动水平,尽管恢复到同等或更高运动水平的马匹数量比之前报道的要少。

临床意义

棘间韧带切断术能使患病马匹恢复到一定程度的运动水平,而与放射学和闪烁扫描结果的严重程度无关。

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