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犬微创脊柱手术:胸腰椎入路脊髓的安全性和可行性评估

Minimally invasive spine surgery in dogs: Evaluation of the safety and feasibility of a thoracolumbar approach to the spinal cord.

作者信息

Guevar Julien, Zidan Natalia, Durand Alexane, Olby Natasha J

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.

Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin.

出版信息

Vet Surg. 2020 Jun;49 Suppl 1:O76-O85. doi: 10.1111/vsu.13385. Epub 2020 Jan 30.

Abstract

OBJECTIVE

To describe the safety and feasibility of a minimally invasive spine surgery technique to access the thoracolumbar vertebral canal in dogs.

STUDY DESIGN

Prospective study.

ANIMALS

Six healthy research dogs.

METHODS

Dogs were placed under anesthesia for MRI to evaluate vertebral column and spinal cord integrity. Minimally invasive surgery was performed at multiple sites. Access to the vertebral canal was achieved by means of foraminotomy, discectomy, and lateral minicorpectomy by using minimally invasive access and a surgical microscope. Sequential neurological examinations, pressure algometry pain quantification, and creatine kinase levels were evaluated before and after surgery for 7 days. Magnetic resonance imaging, computed tomography, and histopathology were performed on day 6 postoperatively after animals were humanely killed to evaluate the impact of surgery on spinal cord, muscles, and bone.

RESULTS

The vertebral canal was successfully accessed, and the ventral aspect of the spinal cord was identified at all sites. No neurological deterioration was observed. Postoperative pain was not different compared with baseline except in one dog on the day after surgery.

CONCLUSION

Minimally invasive spine surgery was a safe and feasible technique to access the thoracolumbar vertebral canal and the ventral aspect of the spinal cord in dogs. Findings supported postoperative pain benefits.

CLINICAL SIGNIFICANCE

Minimally invasive spine surgery is a valid surgical technique to access the thoracolumbar vertebral canal at single or multiple sites in dogs.

摘要

目的

描述一种用于犬胸腰椎椎管的微创脊柱手术技术的安全性和可行性。

研究设计

前瞻性研究。

动物

6只健康的实验犬。

方法

对犬实施麻醉后进行MRI检查,以评估脊柱和脊髓的完整性。在多个部位进行微创手术。通过椎间孔切开术、椎间盘切除术和外侧微型椎体切除术,利用微创入路和手术显微镜进入椎管。在术后7天内,对手术前后的犬进行连续的神经学检查、压力痛觉测定疼痛量化和肌酸激酶水平评估。在动物实施安乐死后,于术后第6天进行磁共振成像、计算机断层扫描和组织病理学检查,以评估手术对脊髓、肌肉和骨骼的影响。

结果

所有部位均成功进入椎管,并识别出脊髓腹侧。未观察到神经功能恶化。除了一只犬在术后第一天外,术后疼痛与基线相比无差异。

结论

微创脊柱手术是一种安全可行的技术,可用于犬胸腰椎椎管及脊髓腹侧的手术。研究结果支持术后疼痛减轻的益处。

临床意义

微创脊柱手术是一种有效的手术技术,可用于犬单部位或多部位胸腰椎椎管的手术。

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