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磁共振评估的椎间盘退变与手术治疗胸腰椎椎间盘突出症犬的晚期临床复发的相关性。

Association of magnetic resonance assessed disc degeneration and late clinical recurrence in dogs treated surgically for thoracolumbar intervertebral disc extrusions.

机构信息

Dovecote Veterinary Hospital, Derby, UK.

The Queen's Veterinary School Hospital, Department of Clinical Veterinary Medicine, University of Cambridge, Cambridge, UK.

出版信息

J Vet Intern Med. 2021 Jan;35(1):378-387. doi: 10.1111/jvim.15989. Epub 2020 Dec 7.

Abstract

BACKGROUND

Radiographic signs of intervertebral disc mineralization are thought to indicate sites of future recurrence of disc extrusion (Hansen type I) but the relationship between evidence of disc degeneration on magnetic resonance imaging (MRI) and future disc extrusion with recurrence of clinical signs has not been examined.

OBJECTIVES

To examine the relationship between MRI-assessed degeneration of thoracolumbar intervertebral discs and late recurrence of clinical signs in dogs presented with acute thoracolumbar intervertebral disc extrusion and treated by hemilaminectomy alone.

ANIMALS

Ninety-two client-owned dogs presented to 2 referral hospitals between 2009 and 2014.

METHODS

Retrospective analysis of association between clinical signs consistent with recurrent thoracolumbar intervertebral disc extrusion and MRI evidence of disc degeneration in dogs undergoing hemilaminectomy for acute thoracolumbar intervertebral disc extrusion. Univariable and multivariable Cox regression analyses were used to explore associations between recurrence of clinical signs and several characteristics of T10-L3 discs at initial diagnosis.

RESULTS

Ninety-two cases were included, of which 42 (46%) were Dachshunds and median age was 5.3 years. Clinical signs recurred in 33/92 (36%) dogs. Finding a completely degenerate disc in the T10 to L3 region (in addition to the operated site) at the time of surgery was associated with a hazard ratio of 2.92 (95% confidence interval: 1.37-6.20) for recurrence of clinical signs.

CONCLUSIONS AND CLINICAL IMPORTANCE

Our results suggest that in cases of thoracolumbar intervertebral disc extrusion in dogs, recurrence of signs is likely if at least 1 completely degenerate disc in addition to the currently symptomatic disc is visible on MRI.

摘要

背景

椎骨间盘矿化的放射学征象被认为预示着未来间盘突出(Hansen Ⅰ型)的复发部位,但磁共振成像(MRI)上椎间盘退变的证据与未来伴有临床症状复发的间盘突出之间的关系尚未被研究。

目的

研究 MRI 评估的胸腰椎间盘退变与急性胸腰椎间盘突出症接受半椎板切除术治疗后出现临床症状复发的犬之间的关系。

动物

2009 年至 2014 年,2 家转诊医院共收治了 92 只患犬。

方法

回顾性分析 92 只接受半椎板切除术治疗急性胸腰椎间盘突出症的犬,在接受半椎板切除术时与 MRI 评估的椎间盘退变相关的临床症状与 MRI 评估的椎间盘退变之间的关系。采用单变量和多变量 Cox 回归分析探讨了初次诊断时 T10-L3 椎间盘的几个特征与临床症状复发之间的关系。

结果

92 例病例中,42 例(46%)为腊肠犬,中位年龄为 5.3 岁。92 例中有 33 例(36%)犬出现临床症状复发。手术时 T10 到 L3 区域(除手术部位外)存在完全退变的椎间盘与临床症状复发的风险比(hazard ratio,HR)为 2.92(95%置信区间:1.37-6.20)。

结论和临床意义

我们的研究结果表明,在犬的胸腰椎间盘突出症病例中,如果除了当前有症状的椎间盘外,至少有 1 个完全退变的椎间盘在 MRI 上可见,那么出现症状复发的可能性较大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2438/7848362/d37fd384d966/JVIM-35-378-g001.jpg

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