Brown Kara A, Davidson Elizabeth J, Ortved Kyla, Ross Michael W, Stefanovski Darko, Wulster Kathryn B, Levine David G
Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania.
Vet Surg. 2020 Apr;49(3):590-599. doi: 10.1111/vsu.13377. Epub 2020 Jan 9.
To report the long-term outcome of horses treated with interspinous ligament desmotomy (ISLD) for pain associated with overriding dorsal spinous processes (ORDSP) and determine the influence of preoperative diagnostic analgesia on long-term outcome.
Retrospective study.
Eighteen horses.
Data were collected from horses presenting for ISLD to the University of Pennsylvania New Bolton Center between January 2013 and May 2018. Follow-up of ≥3 months postsurgically was obtained from the owner, trainer, or referring veterinarian. Long-term improvement was compared between horses that improved with diagnostic analgesia presurgically and horses that did not undergo diagnostic analgesia presurgically by using a χ test. Univariate logistic regression was used to test associations between long-term improvement and independent variables.
Clinical signs had improved in 13 of 18 horses at long-term follow-up (median, 14.5 months; range, 3-57). Clinical signs improved in nine of 10 horses responding to diagnostic analgesia but only in four of eight horses that did not undergo diagnostic analgesia (χ [1], N = 18) = 3.55; P = .06). Although the likelihood of long-term improvement increased with prior diagnostic analgesia (odds ratio = 6.3; 95% confidence interval = 0.73, 55.0; P = .09), it did not reach statistical significance.
A higher proportion of horses experienced long-term improvement in clinical signs after ISLD when horses responding to preoperative diagnostic analgesia were compared with horses that were not tested.
This study provides some evidence to support the use of diagnostic analgesia in conjunction with clinical examination for identification of clinically relevant ORDSP.
报告采用棘间韧带切断术（ISLD）治疗因背侧棘突重叠（ORDSP）引起疼痛的马匹的长期预后，并确定术前诊断性镇痛对长期预后的影响。
回顾性研究。
18匹马。
收集2013年1月至2018年5月间到宾夕法尼亚大学新博尔顿中心接受ISLD治疗的马匹的数据。术后≥3个月的随访信息来自马主、驯马师或转诊兽医。通过χ检验比较术前诊断性镇痛有效的马匹和未进行术前诊断性镇痛的马匹的长期改善情况。采用单因素逻辑回归分析长期改善与自变量之间的关联。
在长期随访中，18匹马中有13匹的临床症状得到改善（中位数为14.5个月；范围为3 - 57个月）。对诊断性镇痛有反应的10匹马中有9匹临床症状得到改善，但未进行诊断性镇痛的8匹马中只有4匹临床症状得到改善（χ[1]，N = 18）= 3.55；P = 0.06）。虽然术前诊断性镇痛使长期改善的可能性增加（优势比 = 6.3；95%置信区间 = 0.73，55.0；P = 0.09），但未达到统计学显著性。
与未进行检测的马匹相比，对术前诊断性镇痛有反应的马匹在接受ISLD治疗后，有更高比例的马匹临床症状得到长期改善。
本研究提供了一些证据，支持将诊断性镇痛与临床检查相结合用于识别临床上相关的ORDSP。
