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犬颈椎髓核脱出相关的临床特征

Clinical characteristics associated with cervical hydrated nucleus pulposus extrusion in dogs.

作者信息

Lin Megan, Hong Christopher X, Rishniw Mark, Davies Emma S, Wood Jonathan H

机构信息

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

Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

J Vet Intern Med. 2025 Jan-Feb;39(1):e17284. doi: 10.1111/jvim.17284.

Abstract

BACKGROUND

Clinical characteristics of cervical hydrated nucleus pulposus extrusion (HNPE) in dogs compared to other causes of cervical myelopathy are not well described.

HYPOTHESIS/OBJECTIVES: To evaluate for clinical characteristics and mechanical ventilation likelihood associated with HNPE compared to other causes of cervical myelopathy.

ANIMALS

Three hundred seventy-seven client-owned dogs from 2010 to 2022. Cases included 46 HNPE, 192 IVDE (intervertebral disc extrusion), 30 FCEM (fibrocartilaginous embolic myelopathy), 66 CSM (cervical spondylomyelopathy), and 43 neoplasia.

METHODS

Retrospective study with record review and bivariate analyses. Dogs with signs of cervical myelopathy and an MRI diagnosis of HNPE, IVDE, FCEM, CSM, or neoplasia were included.

RESULTS

When compared to dogs with other cervical myelopathies, dogs with HNPE were more likely to be older and of lower weight (median age 10 vs 8 years, P < .001; median weight 9.1 vs 20.2 kg, P < .001), be nonambulatory (89% vs 54%, P < .001), have signs of central cord syndrome (35% vs 16%, P = .002), and have nonlateralizing signs of myelopathy (65% vs 48%, P = .029). When compared to dogs with IVDE, dogs with HNPE were more likely to present with lower pain scores (30% vs 15% nonpainful, P = .002), and require mechanical ventilation (4/46 HNPE, 2/192 IVDE; odds ratio [OR] 9.0, 95% confidence interval [CI] 1.6-51.0).

CONCLUSIONS AND CLINICAL IMPORTANCE

Compared to dogs with other cervical myelopathies, dogs with HNPE have differences in clinical characteristics, presentation and likelihood of requiring mechanical ventilation. These differences are important to consider for case management.

摘要

背景

与其他导致犬颈椎脊髓病的病因相比,犬颈椎髓核突出(HNPE)的临床特征尚未得到充分描述。

假设/目的:评估与其他导致犬颈椎脊髓病的病因相比,HNPE相关的临床特征及机械通气可能性。

动物

2010年至2022年的377只客户拥有的犬。病例包括46例HNPE、192例椎间盘突出(IVDE)、30例纤维软骨栓塞性脊髓病(FCEM)、66例颈椎病性脊髓病(CSM)和43例肿瘤。

方法

采用回顾性研究,进行记录审查和双变量分析。纳入有颈椎脊髓病体征且MRI诊断为HNPE、IVDE、FCEM、CSM或肿瘤的犬。

结果

与患有其他颈椎脊髓病的犬相比,患有HNPE的犬更可能年龄较大且体重较轻(中位年龄10岁对8岁,P <.001;中位体重9.1 kg对20.2 kg,P <.001),不能行走(89%对54%,P <.001),有中央脊髓综合征体征(35%对16%,P =.002),以及有脊髓病的非定位体征(65%对48%,P =.029)。与患有IVDE的犬相比,患有HNPE的犬更可能疼痛评分较低(无疼痛的比例为30%对15%,P =.002),且需要机械通气(46例HNPE中有4例,192例IVDE中有2例;优势比[OR]为9.0,95%置信区间[CI]为1.6 - 51.0)。

结论及临床意义

与患有其他颈椎脊髓病的犬相比,患有HNPE的犬在临床特征、表现及机械通气需求可能性方面存在差异。这些差异在病例管理中很重要,需加以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0513/11724192/115a1db548ba/JVIM-39-e17284-g001.jpg

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