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行半椎板切除术或广泛半椎板切除术和硬脊膜切开术治疗进行性脊髓软化症犬的结果。

Outcomes of dogs with progressive myelomalacia treated with hemilaminectomy or with extensive hemilaminectomy and durotomy.

机构信息

Kyoto Animal Referral Medical Center, Kyoto, Kuze-gun, Japan.

Neuro Vets Animal Neurology Clinic, 4th floor, 550-4, Bishamon-cho, Nakgyo-ku, Japan.

出版信息

Vet Surg. 2021 Jan;50(1):81-88. doi: 10.1111/vsu.13514. Epub 2020 Sep 29.

Abstract

OBJECTIVE

To evaluate the ability of extensive hemilaminectomy and durotomy (EHLD) to control progressive myelomalacia (PMM) in dogs.

STUDY DESIGN

Retrospective clinical study.

ANIMALS

Twenty-eight client owned dogs that underwent EHLD (n = 10) or HL alone (n = 18).

METHODS

After diagnosis by MRI, dogs were immediately treated with HL alone or EHLD at the site of intramedullary hyperintensity on T2-weighted (T2W)-MRI. Medical records were retrospectively reviewed. Follow-up data were collected via telephone interviews with the referring veterinarian and a standardized questionnaire. Postoperative survival outcome between groups was compared (log-rank test) by using Cox's proportional hazard analysis with baseline characteristics entered as covariates.

RESULTS

The survival rate was higher in the EHLD group (P = .03) compared with the HL-alone group. Eleven of 18 dogs treated with HL survived, while seven of 18 dogs died (median, 5 days after surgery). In the EHLD group, 10 of 10 dogs survived postoperatively. Baseline characteristics were not associated with postoperative survival outcomes. According to multivariate analysis, EHLD was the independent factor associated with an increase in survival rate (P = .0002).

CONCLUSION

EHLD durotomy at the intramedullary hyperintense region on T2W-MRI improved the survival rate of dogs with PMM compared with dogs treated with standard HL.

CLINICAL SIGNIFICANCE

This study provides evidence that supports treatment with EHLD in dogs with PMM. Additional prospective studies are required.

摘要

目的

评估广泛半椎板切除术和硬脊膜切开术(EHLD)控制犬进行性脊髓软化症(PMM)的能力。

研究设计

回顾性临床研究。

动物

28 只接受 EHLD(n = 10)或 HL 单独治疗(n = 18)的患犬。

方法

通过 MRI 诊断后,立即在 T2 加权(T2W)MRI 上的髓内高信号部位对犬进行 HL 单独或 EHLD 治疗。回顾性审查病历。通过与转诊兽医的电话访谈和标准化问卷收集随访数据。使用 Cox 比例风险分析比较组间术后生存结果(log-rank 检验),并将基线特征作为协变量纳入。

结果

EHLD 组的生存率高于 HL 单独组(P =.03)。18 只接受 HL 治疗的犬中有 11 只存活,而 18 只犬中有 7 只死亡(中位数为手术后 5 天)。在 EHLD 组中,10 只犬术后均存活。基线特征与术后生存结果无关。根据多变量分析,EHLD 是与生存率提高相关的独立因素(P =.0002)。

结论

在 T2W-MRI 上的髓内高信号区域进行 EHLD 硬脊膜切开术可提高 PMM 犬的生存率,优于接受标准 HL 治疗的犬。

临床意义

本研究提供了支持 EHLD 治疗 PMM 犬的证据。需要进一步的前瞻性研究。

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