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术后MRI测量的挤出椎间盘材料的残余体积和残余脊髓压迫不能预测胸腰椎椎间盘挤出减压手术后犬的神经学结果。

Residual volume of extruded disc material and residual spinal cord compression measured on postoperative MRI do not predict neurological outcomes in dogs following decompressive surgery for thoracolumbar intervertebral disc extrusion.

作者信息

Auffret Vincent, Castel Aude, Juette Tristan, Finck Cyrielle

机构信息

Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Quebec, Canada.

Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Quebec, Canada.

出版信息

Vet Radiol Ultrasound. 2024 Mar;65(2):76-86. doi: 10.1111/vru.13325. Epub 2024 Jan 6.

Abstract

Published studies on the validity of using quantitative MRI measures of pre- and postoperative spinal cord (SC) compression as prognostic indicators for dogs undergoing surgery for intervertebral disc extrusion (IVDE) are currently limited. The aim of this retrospective analytical study was to describe the volume of postoperative residual extradural material (VREM) and the ratio of the cross-sectional area (CSA) of maximum SC compression to the CSA of SC in a compression-free intervertebral space as MRI measures of preoperative and postoperative compression (residual spinal cord compression, RSCC), and to compare these measures between the neurological outcome in a group of dogs. Inclusion criteria were dogs that underwent surgery for thoracolumbar IVDE, were imaged pre- and immediately postoperatively by MRI, and had a neurological follow-up examination 2 to 5 weeks postoperatively. Two blinded observers independently performed measurements in pre- and postoperative MRI studies. Dogs were classified into positive outcome (PO) and negative outcome (NO) groups based on follow-up neurologic examination scores. Seventeen dogs were included (12 PO, 5 NO). Interobserver agreement for MRI measurements was good to excellent (ICCs: 0.76-0.97). The prevalence of residual extradural material in postoperative MRI studies was 100%. No significant differences in mean preoperative SC compression, mean RSCC, mean SC decompression, or VREM were found between outcome groups (P = .25; P = .28; P = .91, P = .98). In conclusion, neither postoperative VREM nor RSCC could predict successful neurological outcomes.

摘要

目前,关于将术前和术后脊髓(SC)压迫的定量MRI测量作为椎间盘突出症(IVDE)手术犬预后指标有效性的已发表研究有限。这项回顾性分析研究的目的是描述术后残余硬膜外物质的体积(VREM)以及最大SC压迫的横截面积(CSA)与无压迫椎间空间中SC的CSA之比,作为术前和术后压迫(残余脊髓压迫,RSCC)的MRI测量指标,并比较一组犬的神经学结果之间的这些指标。纳入标准为接受胸腰椎IVDE手术、术前和术后立即进行MRI成像且术后2至5周进行神经学随访检查的犬。两名盲法观察者在术前和术后MRI研究中独立进行测量。根据随访神经学检查评分,将犬分为阳性结果(PO)组和阴性结果(NO)组。共纳入17只犬(12只PO,5只NO)。MRI测量的观察者间一致性良好至优秀(ICC:0.76 - 0.97)。术后MRI研究中残余硬膜外物质的患病率为100%。结果组之间在术前平均SC压迫、平均RSCC、平均SC减压或VREM方面未发现显著差异(P = 0.25;P = 0.28;P = 0.91,P = 0.98)。总之,术后VREM和RSCC均不能预测神经学结果是否成功。

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