Awake Djursjukhus, Hornsgatan 150A, Stockholm, 117 28, Sweden.
ChesterGates Veterinary Specialists, Units E & F, Telford Court, Gates Lane, Chester, Cheshire, CH1 6LT, UK.
Acta Vet Scand. 2023 Aug 29;65(1):37. doi: 10.1186/s13028-023-00700-2.
Bone overgrowth after decompressive surgery for lumbar stenosis resulting in recurrence of neurological signs has not been reported in veterinary literature. However, there are few cases described in human medicine.
A 13-month-old entire female dog, a crossbreed between a Springer Spaniel and a Border Collie, weighing 24 kg, was referred with a 5-day history of progressive spastic paraplegia, indicative of a T3-L3 myelopathy. Magnetic resonance (MR) imaging revealed a right-sided L2-L3 compressive extradural lesion, compatible with epidural haemorrhage, which was confirmed by histopathology. The lesion was approached via right-sided L2-L3 hemilaminectomy and was successfully removed. One-year postoperatively the dog re-presented with pelvic limb ataxia. MR and computed tomography (CT) images demonstrated excessive vertebral bone formation affecting the right articular processes, ventral aspect of the spinous process of L2-L3, and contiguous vertebral laminae, causing spinal cord compression. Revision surgery was performed, and histopathology revealed normal or reactive osseous tissue with a possible chondroid metaplasia and endochondral ossification, failing to identify a definitive reason for the bone overgrowth. Nine-month postoperatively, imaging studies showed a similar vertebral overgrowth, resulting in minimal spinal cord compression. The patient remained stable with mild proprioceptive ataxia up until the last follow-up 18 months post-revision surgery.
This is the first report in the veterinary literature of bone overgrowth after lumbar hemilaminectomy which resulted in neurological deficits and required a revision decompressive surgery.
减压手术后腰椎狭窄症导致的骨过度生长，从而导致神经体征复发，在兽医文献中尚未报道。然而，在人类医学中已有少数病例描述。
一只 13 月龄的全雌性犬，是一只由史宾格犬和边境牧羊犬杂交的犬，体重 24 公斤，因进行性痉挛性截瘫就诊，提示存在 T3-L3 脊髓病变。磁共振成像（MR）显示右侧 L2-L3 压迫性硬膜外病变，符合硬膜外血肿，组织病理学证实了这一诊断。该病变通过右侧 L2-L3 半椎板切除术进行治疗，并成功切除。术后 1 年，该犬再次出现骨盆支共济失调。MR 和计算机断层扫描（CT）图像显示，过多的椎骨形成影响了右侧关节突、L2-L3 棘突的腹侧和连续的椎板，导致脊髓受压。进行了 revision 手术，组织病理学显示正常或反应性骨组织，可能存在软骨样化生和软骨内骨化，但未能确定骨过度生长的明确原因。术后 9 个月，影像学研究显示类似的椎体过度生长，导致脊髓受压轻微。revision 手术后 18 个月的最后一次随访时，该犬仍保持稳定，仅有轻度本体感觉共济失调。
这是兽医文献中首例报道的腰椎半椎板切除术后骨过度生长导致神经功能缺损并需要 revision 减压手术的病例。
