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对12只猫进行部分侧方椎体切除术治疗胸腰椎间盘突出症的回顾性研究。

Retrospective study of partial lateral corpectomy to treat thoracic and lumbar intervertebral disc herniation in 12 cats.

作者信息

Tyroller Florian, Wennemuth Jan, Forterre Franck, Flegel Thomas, Markert Carina, Kiefer Ingmar, Wunderlin Nadja

机构信息

Kleintierzentrum Germering, Germering, Germany.

Tierklinik Hofheim, Hofheim, Germany.

出版信息

J Feline Med Surg. 2024 Dec;26(12):1098612X241299276. doi: 10.1177/1098612X241299276.

Abstract

OBJECTIVES

The aim of this study was to describe the safety and effectiveness of thoracic or lumbar partial lateral corpectomy (PLC) in cats with spinal cord compression due to intervertebral disc herniation (IVH).

METHODS

A retrospective study was conducted of 12 client-owned cats from two academic and one private referral veterinary centres. Cross-sectional imaging was available in 12 cats for evaluation of disc herniation. Nine cats had postoperative imaging for evaluation of slot creation and decompression. Neurological examination was performed for assessment of pre- and postoperative status. Complications were evaluated.

RESULTS

Seven cats had severe (>50%), four moderate (>20 to <50%) and one mild (<20%) spinal cord compression on cross-sectional imaging. IVH occurred at Th12-13 in five cases, at L1-2 in two cases and at Th3-4, Th13-L1, L4-5 and L5-6 in one case each. After PLC, two cats had insufficient decompression (>20% remaining spinal cord compression), five had good decompression (<20% remaining spinal cord compression) and complete decompression (normal shape of the spinal cord) was achieved in two cats. Outcomes included five cats with an excellent result, three with significant improvement, one with mild improvement and three cats that died intra- or postoperatively due to extensive intraoperative bleeding. One cat was euthanased as a result of neurological deterioration 5 months postoperatively. The median follow-up period was 13.2 months (range 0 days to 84 months).

CONCLUSIONS AND RELEVANCE

PLC in cats offers a potential treatment option for IVH to decompress the spinal cord. Fatal haemorrhage associated with this surgery is a significant risk, as occurred in 25% of the cats in this study. Surgeons should especially be aware of the potential for intraoperative haemorrhage and the need for sufficient slot creation to achieve sufficient spinal cord decompression and avoid complications.

摘要

目的

本研究旨在描述胸椎或腰椎部分侧方椎体切除术(PLC)治疗猫椎间盘突出症(IVH)所致脊髓压迫的安全性和有效性。

方法

对来自两个学术性和一个私立转诊兽医中心的12只客户拥有的猫进行回顾性研究。12只猫有横断面成像用于评估椎间盘突出情况。9只猫术后有成像用于评估开槽和减压情况。进行神经学检查以评估术前和术后状态。评估并发症情况。

结果

横断面成像显示,7只猫有严重(>50%)脊髓压迫,4只猫有中度(>20%至<50%)脊髓压迫,1只猫有轻度(<20%)脊髓压迫。IVH发生于胸12 - 13节段5例,腰1 - 2节段2例,胸3 - 4、胸13 - 腰1、腰4 - 5和腰5 - 6节段各1例。PLC术后,2只猫减压不足(脊髓压迫残留>20%),5只猫减压良好(脊髓压迫残留<20%),2只猫实现了完全减压(脊髓形态正常)。结果包括5只猫效果极佳,3只猫有显著改善,1只猫有轻度改善,3只猫因术中大量出血在术中或术后死亡。1只猫术后5个月因神经功能恶化被安乐死。中位随访期为13.2个月(范围0天至84个月)。

结论及意义

猫的PLC为IVH减压脊髓提供了一种潜在的治疗选择。与该手术相关的致命性出血是一个重大风险,本研究中有25%的猫发生了这种情况。外科医生应特别注意术中出血的可能性以及充分开槽以实现充分脊髓减压并避免并发症的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a66c/11682589/8b7fb6787401/10.1177_1098612X241299276-fig1.jpg

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