Lewis Melissa J, Jeffery Nick D, Olby Natasha J
Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States.
Department of Small Animal Clinical Sciences, Texas a & M College of Veterinary Medicine and Biomedical Sciences, College Station, TX, United States.
Front Vet Sci. 2020 Aug 26;7:560. doi: 10.3389/fvets.2020.00560. eCollection 2020.
Acute thoracolumbar spinal cord injury (SCI) is common in dogs frequently secondary to intervertebral disc herniation. Following severe injury, some dogs never regain sensory function to the pelvic limbs or tail and are designated chronically "deep pain negative." Despite this, a subset of these dogs develop spontaneous motor recovery over time including some that recover sufficient function in their pelvic limbs to walk independently without assistance or weight support. This type of ambulation is commonly known as "spinal walking" and can take up to a year or more to develop. This review provides a comparative overview of locomotion and explores the physiology of locomotor recovery after severe SCI in dogs. We discuss the mechanisms by which post-injury plasticity and coordination between circuitry contained within the spinal cord, peripheral sensory feedback, and residual or recovered supraspinal connections might combine to underpin spinal walking. The clinical characteristics of spinal walking are outlined including what is known about the role of patient or injury features such as lesion location, timeframe post-injury, body size, and spasticity. The relationship between the emergence of spinal walking and electrodiagnostic and magnetic resonance imaging findings are also discussed. Finally, we review possible ways to predict or facilitate recovery of walking in chronically deep pain negative dogs. Improved understanding of the mechanisms of gait generation and plasticity of the surviving tissue after injury might pave the way for further treatment options and enhanced outcomes in severely injured dogs.
急性胸腰段脊髓损伤（SCI）在犬类中很常见，通常继发于椎间盘突出。严重损伤后，一些犬只的后肢或尾巴永远无法恢复感觉功能，被长期判定为“深部疼痛阴性”。尽管如此，这些犬只中的一部分会随着时间推移出现自发的运动恢复，包括一些后肢恢复了足够功能、能够在无辅助或体重支撑的情况下独立行走的犬只。这种行走方式通常被称为“脊髓性行走”，可能需要长达一年或更长时间才能形成。这篇综述提供了运动的比较概述，并探讨了犬类严重脊髓损伤后运动恢复的生理学机制。我们讨论了损伤后可塑性以及脊髓内神经回路、外周感觉反馈和残留或恢复的脊髓上连接之间的协调可能共同支持脊髓性行走的机制。概述了脊髓性行走的临床特征，包括已知的患者或损伤特征（如损伤部位、损伤后时间、体型和痉挛）的作用。还讨论了脊髓性行走的出现与电诊断和磁共振成像结果之间的关系。最后，我们回顾了预测或促进慢性深部疼痛阴性犬只恢复行走的可能方法。更好地理解损伤后步态产生和存活组织可塑性的机制，可能为严重受伤犬只的进一步治疗选择和改善预后铺平道路。
