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220 例胸腰椎间盘疾病行微创半椎板切除术治疗的犬的短期临床疗效。

Short-term clinical outcomes of 220 dogs with thoraco-lumbar disc disease treated by mini-hemilaminectomy.

机构信息

Department of Companion Animal Clinical Studies, University of Pretoria, Onderstepoort, South Africa; and, Department of Small Animal Surgery, Bryanston Veterinary Hospital, Bryanston.

出版信息

J S Afr Vet Assoc. 2020 Dec 21;91(0):e1-e8. doi: 10.4102/jsava.v91i0.2008.

Abstract

Thoraco-lumbar intervertebral disc extrusion is a common condition seen in veterinary practice. Although there are different surgical techniques described for decompression, most of these techniques are based on the surgeon's preference or experience rather than clinical research. Our objective was to determine the clinical outcomes, using return to ambulation and micturition, as well as complication rates, in a large cohort of dogs by using a mini-hemilaminectomy for decompression of the thoraco-lumbar spinal cord with Hansen type I thoraco-lumbar intervertebral disc extrusions (IVDE). A retrospective study was performed on dogs presented for acute thoraco-lumbar IVDE undergoing surgical decompression. In total, 252 spinal decompression surgeries were performed. The recovery rates for patients graded with a modified Frankel score (MFS) of 5 to 0 were 100%, 99%, 100%, 96%, 86% and 64%, respectively. The mean days to micturition across all the MFS 5-0 were 1.5 (standard deviation [SD] ± 0.7), 1.8 (SD ± 1), 4.3 (SD ± 1.7), 6.4 (SD ± 2.2), 9.3 (SD 3) and 11.9 (SD ± 2.2), respectively. The mean days to ambulation across all the groups 5-0 were 2 (SD ± 0.7), 2.6 (SD ± 1), 7.6 (SD ± 4.4), 10.1 (SD ± 2.5), 16.1 (SD ± 2.9) and 19.3 (SD ± 2.6), respectively. Postoperative complications were seen in 32 of the surgeries, with a complication rate of 13%. Minor complications accounted for 38% of all complications, and major complications constituted 62% of all complications. In total, 15 dogs died or were euthanised as a direct result of thoraco-lumbar disc extrusion or the surgical procedure, with a mortality rate of 6% across all groups. A mini-hemilaminectomy provides similar clinical outcomes described in the literature for other methods of spinal cord decompressive surgery, and it also provides patients with similar short-term outcomes to other described decompressive surgical techniques in the dog, which have been described in the literature.

摘要

胸腰椎间盘突出是兽医临床中常见的病症。尽管有不同的减压手术技术被描述,但这些技术大多基于外科医生的偏好或经验,而不是临床研究。我们的目的是通过使用迷你半椎板切除术对 Hansen 型 I 胸腰椎间盘突出症(IVDE)进行胸腰椎脊髓减压,确定大量犬只的临床结果,包括恢复行走和排尿以及并发症发生率。对因急性胸腰椎 IVDE 而接受手术减压的犬进行了回顾性研究。共进行了 252 例脊柱减压手术。改良的 Frankel 评分(MFS)为 5 至 0 分的患者的恢复率分别为 100%、99%、100%、96%、86%和 64%。所有 MFS 5-0 级患者的平均排尿时间分别为 1.5(标准差[SD]±0.7)、1.8(SD±1)、4.3(SD±1.7)、6.4(SD±2.2)、9.3(SD 3)和 11.9(SD±2.2)。所有 MFS 5-0 级患者的平均行走时间分别为 2(SD±0.7)、2.6(SD±1)、7.6(SD±4.4)、10.1(SD±2.5)、16.1(SD±2.9)和 19.3(SD±2.6)。32 例手术出现术后并发症,并发症发生率为 13%。轻微并发症占所有并发症的 38%,严重并发症占所有并发症的 62%。总共 15 只狗因胸腰椎间盘突出或手术直接死亡或安乐死,所有组的死亡率为 6%。迷你半椎板切除术提供了与文献中其他脊髓减压手术方法相似的临床结果,并且与文献中描述的其他犬只减压手术技术提供了相似的短期结果。

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