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拳师犬颅尾关节突畸形相关胸腰椎不稳定的脊柱稳定化治疗:七例报告(2010-2019 年)。

Vertebral stabilisation for thoracolumbar vertebral instability associated with cranial and caudal articular process anomalies in pugs: Seven cases (2010-2019).

机构信息

Department of Surgery, Aikawa Veterinary Medical Center, Tokyo, Japan.

Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA.

出版信息

J Small Anim Pract. 2022 Sep;63(9):699-706. doi: 10.1111/jsap.13505. Epub 2022 May 16.

Abstract

OBJECTIVES

To describe the diagnostic findings, surgical technique and outcomes in seven pugs with thoracolumbar vertebral instability due to articular process anomalies.

MATERIALS AND METHODS

Records (2010 to 2019) of pugs with thoracolumbar vertebral instability associated with articular process anomalies that underwent decompressive laminectomy and vertebral stabilisation were reviewed. Data on preoperative and postoperative neurologic status, diagnostic findings, surgical techniques and outcomes were retrieved.

RESULTS

Seven dogs were presented with ambulatory or non-ambulatory paraparesis. Caudal articular process anomalies (three dogs) and concomitant cranial and caudal articular process anomalies (four dogs) were noted. Myelography (six dogs) or magnetic resonance imaging (one dog) showed none to severe spinal cord compression. Dynamic myelography in six dogs demonstrated nine distinct sites of spinal cord dimension reduction positioned in extension and/or flexion (mean reduction: 16.0%, range: 8.5 to 24.0%). These dynamic compressions were located at sites with articular process anomalies (seven sites) and sites with no articular process anomalies (two sites). Vertebral instability was confirmed by intraoperative spinal manipulation in all dogs. All dogs remained ambulatory with improved (five dogs) or static (two dogs) neurological deficits at the last follow-up (median: 16 months; range: 1.5 to 66 months).

CLINICAL SIGNIFICANCE

Dynamic myelography and/or intraoperative spinal manipulation demonstrated vertebral instabilities at sites with or without articular process anomalies on imaging. Decompressive laminectomy with vertebral stabilisation resulted in long-term neurological improvement in most dogs.

摘要

目的

描述 7 例因关节突异常导致胸腰椎不稳定的哈巴狗的诊断结果、手术技术和结果。

材料和方法

回顾了 2010 年至 2019 年间接受减压性椎板切除术和椎体稳定术的伴有关节突异常的胸腰椎不稳定哈巴狗的记录。检索了术前和术后神经状态、诊断结果、手术技术和结果的数据。

结果

7 只狗表现为可走动或不可走动的后肢轻瘫。发现尾侧关节突异常(3 只狗)和同时存在的头侧和尾侧关节突异常(4 只狗)。6 只狗进行了脊髓造影,1 只狗进行了磁共振成像,显示无至严重的脊髓压迫。6 只狗的动态脊髓造影显示 9 个不同部位的脊髓尺寸在伸展和/或屈曲时减小(平均减小:16.0%,范围:8.5 至 24.0%)。这些动态压迫位于存在关节突异常的部位(7 个部位)和不存在关节突异常的部位(2 个部位)。所有狗在术中脊柱操作时均确认存在椎体不稳定。所有狗在最后一次随访时仍可走动,神经功能缺损改善(5 只狗)或保持静态(2 只狗)(中位数:16 个月;范围:1.5 至 66 个月)。

临床意义

动态脊髓造影和/或术中脊柱操作显示在影像学上存在或不存在关节突异常的部位存在椎体不稳定。减压性椎板切除术和椎体稳定术可使大多数狗的神经功能长期改善。

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