Neurology/Neurosurgery Service, Langford Vets Small Animal Hospital, Bristol, BS40 5DU, UK.
Neurology/Neurosurgery Service, Willows Veterinary Centre and Referral Services, Solihull, UK.
J Small Anim Pract. 2022 Jul;63(7):520-525. doi: 10.1111/jsap.13486. Epub 2022 Feb 9.
To report the surgical techniques being used to treat single focal spinal intra-arachnoid diverticula in dogs, their complications and immediate postoperative outcomes.
Retrospective multi-centre case series across four referral centres.
Fifty-seven dogs were included in the study. The most common type of surgery was durectomy (28 dogs) followed by marsupialisation (11 dogs), durotomy alone (seven dogs), shunt placement (six dogs) and stabilisation (five dogs). A higher proportion of intra-arachnoid shunt dogs became unable to walk in the immediate postoperative period (24 hours postsurgery) (4/6, 66%) compared to all dogs five of 57, 9% (2/7 durotomy alone, 3/28 durectomy alone). Of the nine dogs with immediate postoperative deterioration, seven had improved, walking without assistance, by 3 to 5 weeks postoperatively.
This study does not identify an influence of surgical technique on short-term outcome. Dogs with a thoracolumbar intra-arachnoid diverticulum that undergo a shunt placement are likely to deteriorate neurologically in the immediate 24-hour postoperative period but appear to improve by 3 to 5 weeks after surgery. Further work is required to evaluate whether one surgical technique is superior for preventing or reducing long-term relapse.
报告用于治疗犬单一局灶性脊髓蛛网膜内憩室的手术技术、其并发症和术后即刻结果。
在四个转诊中心进行回顾性多中心病例系列研究。
本研究纳入了 57 只狗。最常见的手术类型是硬脊膜切开术（28 只狗），其次是蛛网膜下腔造袋术（11 只狗）、单纯硬脊膜切开术（7 只狗）、分流术（6 只狗）和稳定术（5 只狗）。在术后即刻（术后 24 小时），蛛网膜下腔分流术组中无法行走的狗比例较高（4/6，66%），而非所有狗（5/57，9%）（2/7 单纯硬脊膜切开术，3/28 单纯硬脊膜切开术）。在 9 只术后即刻恶化的狗中，有 7 只在术后 3 至 5 周时得到改善，无需辅助行走。
本研究未发现手术技术对短期结果有影响。接受分流术的胸腰椎蛛网膜内憩室狗在术后即刻 24 小时内神经功能可能恶化，但在术后 3 至 5 周时似乎有所改善。需要进一步研究评估哪种手术技术更能预防或减少长期复发。
