Okuno Seiichi, Katahira Hirotaka, Orito Kensuke
Laboratory of Physiology II, School of Veterinary Medicine, Azabu University, Sagamihara, Japan.
Veterinary Clinic of Neurology, Isesaki, Japan.
Front Vet Sci. 2022 Sep 15;9:976972. doi: 10.3389/fvets.2022.976972. eCollection 2022.
This study aimed to identify the impact on spinal cord integrity and determine the electrophysiological safety level during surgery for thoracolumbar intervertebral disk herniation in dogs. A total of 52 dogs diagnosed with thoracolumbar intervertebral disk herniation were enrolled. The tibial nerve somatosensory evoked potential elicited on the scalp by stimulation of the tibial nerve was recorded before and during hemilaminectomy. Both the amplitude and latency of the somatosensory evoked potential were periodically registered, and the percentage changes from the pre-operative control values (amplitude rate and latency rate) were calculated. When the multifidus muscles were retracted after removal from the spinous processes and vertebrae, the somatosensory evoked potential amplitude rate decreased in all dogs, while the latency rate increased in 33 dogs examined. The amplitude rate remained unchanged during the halting procedure, loosening retraction, and hemilaminectomy. After removing the disc material from the spinal canal, the amplitude rate was increased. The somatosensory evoked potential latency increased when the multifidus muscles were retracted and shortened after multifidus muscles closure in four cases. The outcome of all cases showed improvement in clinical signs 7 days after operation. Spinal cord conduction is impaired by retraction of the multifidus muscles and improved by removal of disk materials. Maintaining intraoperative SEP amplitudes above 50% of control may help avoid additional spinal cord injury during surgery. Since we have no case that worsened after the surgery, however, further studies are necessary to confirm this proposal.
本研究旨在确定对脊髓完整性的影响,并确定犬胸腰椎椎间盘突出症手术期间的电生理安全水平。总共纳入了52只被诊断为胸腰椎椎间盘突出症的犬。在半椎板切除术之前和期间,记录刺激胫神经在头皮上引出的胫神经体感诱发电位。定期记录体感诱发电位的波幅和潜伏期,并计算与术前对照值相比的变化百分比(波幅率和潜伏期率)。当多裂肌从棘突和椎骨分离后被牵开时,所有犬的体感诱发电位波幅率均下降,而在检查的33只犬中潜伏期率增加。在停止操作、放松牵开和半椎板切除术期间,波幅率保持不变。从椎管中取出椎间盘物质后,波幅率增加。在4例中,多裂肌缝合后牵开并缩短多裂肌时,体感诱发电位潜伏期增加。所有病例的结果显示术后7天临床症状有所改善。多裂肌的牵开损害脊髓传导,而取出椎间盘物质可改善脊髓传导。术中保持体感诱发电位波幅高于对照值的50%可能有助于避免手术期间额外的脊髓损伤。然而,由于我们没有术后病情恶化的病例,因此需要进一步研究来证实这一建议。