Department of Clinical Veterinary Science, Vetsuisse-Faculty, Small Animal Clinic, University of Bern, Bern, Switzerland.
Tierklinik Hofheim, Small Animal Clinic, Hofheim am Taunus, Germany.
Acta Vet Scand. 2021 Aug 23;63(1):30. doi: 10.1186/s13028-021-00596-w.
Intervertebral disc extrusions in the thoracolumbar region are a common spinal neurologic disorder in dogs and usually considered a neurological emergency. Several factors, like timing of surgery, have previously been analysed in order to determine the effect on outcome and time of recovery. Most studies have investigated one defined population of dogs and the influence of a single factor on the overall outcome. In this retrospective study, a large cohort of dogs and the influence of one or combinations of several factors on outcome and time of recovery were analysed.
The bivariate analysis demonstrated a significant association between the following variables and the time of recovery: the time span between the onset of clinical signs and surgery (Cramers Phi [Formula: see text] = 0.14; P = 0.003), the grade of severity ([Formula: see text] = 0.23; P < 0.001) and the implementation of physical rehabilitation ([Formula: see text] = 0.2; P < 0.001). However, the analysis of a multivariable regression model demonstrated that a significant correlation only exists between the time span between the onset of clinical signs and surgery and the overall outcome (P = 0.007), as well as between the grade of severity and the time of recovery (P < 0.001). The percentage of dogs with lacking deep pain perception (DPP) that had to be euthanised due to their neurological condition, decreased from 20.0 to 2.9% when physical rehabilitation was implemented. Additionally, the proportion of dogs (same group) that improved to reach an ambulatory status increased from 80.0 to 91.4%.
The results of the bivariate analysis demonstrated several correlations between some variables and overall outcome or time of recovery, whereas the multivariable regression model demonstrated only two associations. The time span between the onset of clinical signs and surgery was significantly associated with the overall outcome. We therefore suggest that a surgical intervention should be performed without unreasonable delay. Due to the correlation between the grade of severity and time of recovery, owners of dogs with more severe neurological deficits prior to surgery should be informed about the presumably prolonged time of recovery.
胸腰椎椎间盘突出是犬常见的脊柱神经疾病，通常被视为神经急症。此前已经分析了手术时机等多种因素，以确定其对预后和恢复时间的影响。大多数研究都调查了一个特定的犬种群体，并研究了单一因素对整体预后的影响。在这项回顾性研究中，分析了一个大型犬种群体，并研究了一个或多个因素对预后和恢复时间的影响。
双变量分析表明，以下变量与恢复时间之间存在显著关联：临床症状发作与手术之间的时间间隔（Cramers Phi [公式：见文本] = 0.14；P = 0.003）、严重程度等级（[公式：见文本] = 0.23；P < 0.001）和实施物理康复治疗（[公式：见文本] = 0.2；P < 0.001）。然而，多变量回归模型分析表明，仅在临床症状发作与手术之间的时间间隔与整体预后之间（P = 0.007）以及严重程度等级与恢复时间之间（P < 0.001）存在显著相关性。由于神经状况而需要安乐死的缺乏深痛觉（DPP）的犬的百分比从 20.0%降至 2.9%，实施物理康复治疗后。此外，在同一组中，恢复到可走动状态的犬的比例从 80.0%增加到 91.4%。
双变量分析的结果表明，一些变量与整体预后或恢复时间之间存在多种相关性，而多变量回归模型仅显示了两个关联。临床症状发作与手术之间的时间间隔与整体预后显著相关。因此，我们建议应在无不合理延迟的情况下进行手术干预。由于严重程度等级与恢复时间之间存在相关性，因此应告知手术前神经功能缺损较严重的犬的主人恢复时间可能会延长。
