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犬胸腰椎间盘突出症半椎板切除术后的长期术后疼痛评估。

Long-term postoperative pain evaluation in dogs with thoracolumbar intervertebral disk herniation after hemilaminectomy.

机构信息

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

Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA.

出版信息

J Vet Intern Med. 2020 Jul;34(4):1547-1555. doi: 10.1111/jvim.15800. Epub 2020 May 28.

DOI:10.1111/jvim.15800
PMID:32462728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7379041/
Abstract

BACKGROUND

Chronic neuropathic pain is a common complication in people with spinal cord injury (SCI) but has not been investigated in dogs.

OBJECTIVE

To determine the reliability of measuring spinal mechanical sensory thresholds (MSTs) in dogs and to compare MSTs of healthy dogs and dogs with SCI caused by acute thoracolumbar intervertebral disk extrusion after hemilaminectomy over a 1-year period.

STUDY DESIGN

Prospective study.

ANIMALS

Thirty-two healthy and 40 SCI dogs.

METHODS

Dogs were divided into group 1 (healthy Dachshunds), group 2 (healthy dogs including several breeds), and SCI group. The MSTs were measured using algometry at an incision (thoracolumbar) and control site. Dogs in group 1 were tested once; those in group 2 were tested for 5 consecutive days; and SCI dogs were tested on days 7, 14, 28, 42, 180, and 365 postoperatively. The MSTs were compared among days in healthy and SCI dogs and between SCI and healthy dogs using mixed effect models. P < .05 was considered significant.

RESULTS

At the incision site of SCI dogs, MST was significantly lower than in healthy dogs for 42 days postoperatively, but not subsequently. However, 4/27 dogs had control site MST below the reference range 1 year after surgery.

CONCLUSIONS AND CLINICAL IMPORTANCE

Mechanical sensory thresholds normalize by 6 months after surgery in most dogs with SCI. Approximately 15% of SCI dogs may develop chronic neuropathic pain. Improving long-term pain assessment of SCI dogs is important for offering treatment options and advising owners.

摘要

背景

慢性神经性疼痛是脊髓损伤(SCI)患者的常见并发症,但尚未在犬类中进行研究。

目的

确定测量犬脊髓机械感觉阈值(MST)的可靠性,并在 1 年内比较健康犬和接受半椎板切除术治疗的急性胸腰椎椎间盘突出 SCI 犬的 MST。

研究设计

前瞻性研究。

动物

32 只健康犬和 40 只 SCI 犬。

方法

将犬分为 1 组(健康达克斯猎犬)、2 组(包括多个品种的健康犬)和 SCI 组。使用压痛计在切口(胸腰椎)和对照部位测量 MST。第 1 组犬仅测试 1 次,第 2 组犬连续 5 天测试,SCI 犬分别在术后第 7、14、28、42、180 和 365 天测试。使用混合效应模型比较健康犬和 SCI 犬之间以及 SCI 犬和健康犬之间的 MST。P<.05 被认为有统计学意义。

结果

在 SCI 犬的切口部位,术后 42 天 MST 明显低于健康犬,但此后不再如此。然而,手术后 1 年,有 4/27 只犬的对照部位 MST 低于参考范围。

结论和临床意义

大多数 SCI 犬的 MST 在手术后 6 个月内恢复正常。大约 15%的 SCI 犬可能会发展为慢性神经性疼痛。改善 SCI 犬的长期疼痛评估对提供治疗选择和为犬主提供建议很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/999e/7379041/bf21531b633f/JVIM-34-1547-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/999e/7379041/92b983e4a197/JVIM-34-1547-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/999e/7379041/136515cb2044/JVIM-34-1547-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/999e/7379041/bf21531b633f/JVIM-34-1547-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/999e/7379041/92b983e4a197/JVIM-34-1547-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/999e/7379041/136515cb2044/JVIM-34-1547-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/999e/7379041/bf21531b633f/JVIM-34-1547-g003.jpg

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