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13 例犬腰椎-荐椎椎间盘突出症。

Lumbosacral intervertebral disk extrusions in 13 dogs.

机构信息

Small Animal Hospital, School of Veterinary Medicine, University of Glasgow, Glasgow, UK.

Willows Referral Service, Solihull, UK.

出版信息

Vet Surg. 2021 May;50(4):823-832. doi: 10.1111/vsu.13624. Epub 2021 Mar 22.

Abstract

OBJECTIVE

To describe the clinical presentation, magnetic resonance imaging (MRI) findings, and outcome of dogs treated surgically for lumbosacral intervertebral disk extrusion (IVDE).

STUDY DESIGN

Retrospective study.

ANIMALS

Thirteen dogs.

METHODS

Records and MRI studies of dogs with intraoperatively confirmed lumbosacral IVDE were reviewed. MRI features of thoracolumbar IVDE were applied to all cases. Postoperative outcome was subjectively assessed as excellent, good, or poor.

RESULTS

All dogs had an acute or subacute onset of lumbosacral pain and nerve root signature. Seven dogs had neurological deficits. MRI revealed lateralized herniated disk material and partial to complete disk degeneration in all cases; the extradural material extended cranial and/or caudally from the disk space in 10 cases. All dogs underwent L7-S1 dorsal laminectomy and removal of extruded disk material. In six dogs, surgery was complicated by inflammatory changes, including one case of epidural steatitis. On reexamination 4-6 weeks postsurgery, outcome was judged as excellent in 11 dogs and poor in the remaining 2 due to contralateral nerve root signature in one case and nonambulatory paraparesis and urinary incontinence in the case with steatitis.

CONCLUSION

Lumbosacral IVDE in dogs was characterized by acute/subacute onset of lumbosacral pain and nerve root signature and lateralized and often dispersed extradural material over a degenerated L7-S1 intervertebral disk on MRI. Early decompressive dorsal laminectomy generally resulted in excellent clinical outcome.

CLINICAL SIGNIFICANCE

Observation of these clinical and imaging features in dogs should prompt clinical suspicion of lumbosacral IVDE.

摘要

目的

描述手术治疗犬腰椎-荐椎椎间盘突出症(IVDE)的临床症状、磁共振成像(MRI)表现和结果。

研究设计

回顾性研究。

动物

13 只狗。

方法

回顾了经手术证实为腰椎-荐椎 IVDE 的犬的病历和 MRI 研究。将胸腰椎 IVDE 的 MRI 特征应用于所有病例。术后结果主观评估为优秀、良好或差。

结果

所有犬均出现腰椎-荐椎疼痛和神经根特征的急性或亚急性发作。7 只犬有神经功能缺损。MRI 显示所有病例均存在侧方疝出的椎间盘物质和部分至完全椎间盘退变;10 例病例中,硬膜外物质从椎间盘空间向颅侧和/或尾侧延伸。所有犬均行 L7-S1 背侧椎板切除术和突出椎间盘物质切除术。在 6 只犬中,手术出现炎症改变,包括 1 例硬膜外脂膜炎。术后 4-6 周复查时,11 只犬的结果判断为优秀,2 只犬的结果判断为差,其中 1 只犬因对侧神经根特征,1 只犬因伴有脂膜炎的非运动性轻瘫和尿失禁。

结论

犬腰椎-荐椎 IVDE 的特征为腰椎-荐椎疼痛和神经根特征的急性/亚急性发作,以及 MRI 上 L7-S1 椎间盘退变的侧方和常为弥散的硬膜外物质。早期减压性背侧椎板切除术通常可获得良好的临床结果。

临床意义

在犬中观察到这些临床和影像学特征时,应提示临床怀疑腰椎-荐椎 IVDE。

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