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犬腰椎和腰骶部MRI诊断的脊柱病变与疼痛之间关联的多变量分析

Multivariable Analysis of the Association Between Lumbar and Lumbosacral MRI-Diagnosed Spinal Pathologies and Pain in Dogs.

作者信息

Medina-Serra Roger, López-Abradelo Patricia, Belda Eliseo, Riding-Medina Holly, Laredo Francisco G, Marwood Rachel, Mortera Verónica, Redondo José I

机构信息

Anaesthesia and Pain Management, North Downs Specialist Referrals, Bletchingley RH1 4QP, UK.

Escuela Internacional de Doctorado de la Universidad de Murcia, Programa en Ciencias Veterinarias, Universidad de Murcia, 30100 Murcia, Spain.

出版信息

Animals (Basel). 2025 Mar 6;15(5):761. doi: 10.3390/ani15050761.

Abstract

Lumbar and lumbosacral pain in dogs often involves multiple concurrent spinal pathologies, complicating the identification of primary pain generators. This study assessed the associations between MRI-diagnosed spinal pathologies and pain to provide clinically relevant insights for their diagnosis and management. MRI scans and clinical records of 518 client-owned dogs were retrospectively reviewed, documenting demographic data, pain status, and MRI findings. Multivariable logistic regression models evaluated the associations between spinal pathologies and pain, adjusting for age and weight. The intervertebral disc (IVD) extrusion was the primary pathology associated with lumbar pain, while radiculopathy had the strongest association with lumbosacral pain. Additional lumbosacral pathologies, including foraminal stenosis, IVD bulging, and IVD protrusion, were also significantly associated with pain. However, some dogs with MRI-diagnosed abnormalities showed no pain, whereas others with pain had no detectable MRI pathology, underscoring the need to interpret imaging within the clinical context. Pain responses observed during physical examination often overlapped between spinal and hip conditions, complicating diagnostic accuracy. These findings emphasise the importance of integrating imaging, clinical assessment, and targeted diagnostic techniques to improve pain localisation and treatment decisions, providing veterinarians with valuable data to refine the management of lumbar and lumbosacral pain in dogs.

摘要

犬类的腰椎和腰骶部疼痛通常涉及多种并发的脊柱病变,这使得确定主要疼痛源变得复杂。本研究评估了MRI诊断的脊柱病变与疼痛之间的关联,以便为其诊断和管理提供临床相关见解。对518只宠物犬的MRI扫描和临床记录进行了回顾性分析,记录了人口统计学数据、疼痛状况和MRI检查结果。多变量逻辑回归模型评估了脊柱病变与疼痛之间的关联,并对年龄和体重进行了校正。椎间盘(IVD)突出是与腰椎疼痛相关的主要病变,而神经根病与腰骶部疼痛的关联最为密切。其他腰骶部病变,包括椎间孔狭窄、IVD膨出和IVD突出,也与疼痛显著相关。然而,一些MRI诊断有异常的犬没有疼痛表现,而另一些有疼痛的犬则没有可检测到的MRI病变,这突出了在临床背景下解读影像的必要性。体格检查中观察到的疼痛反应在脊柱和髋关节疾病之间常常重叠,这使得诊断准确性变得复杂。这些发现强调了整合影像、临床评估和靶向诊断技术以改善疼痛定位和治疗决策的重要性,为兽医提供了有价值的数据,以优化犬类腰椎和腰骶部疼痛的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/748b/11898813/8358b57955e7/animals-15-00761-g001.jpg

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