Outcome and prognostic factors in nonambulatory Hansen Type I intervertebral disc extrusions: 308 cases

Summary

Thoracolumbar intervertebral disc disease is the most common cause of caudal paresis in dogs (1). Whilst the pathogenesis of the extrusion has been widely studied, treatment protocols and prognostic factors relating to outcome remain controversial. Recent studies have examined a multitude of factors relating to time to regain ambulation after decompressive surgery. Most intervertebral disc herniations occur in the thoracolumbar region, causing upper motor neuron signs in the rear limbs, which are thought to have a more favourable prognosis compared to the lower motor neuron signs created by herniation of an intervertebral disc in the caudal lumbar region. Due to the potential disruption of the lumbar intumescence, lower motor neuron signs have been reported as having a less favourable prognosis. The purpose of this study was to evaluate the intervertebral disc space as a prognostic factor relating to ambulatory outcome and time to ambulation after decompressive surgery. Hansen Type I intervertebral disc extrusions were studied in 308 non-ambulatory dogs. Preoperative and postoperative neurological status, corticosteroid use, signalment, intervertebral disc space, postoperative physical rehabilitation, previous hemilaminectomy surgery, disc fenestration, return to ambulation, and time to ambulation were reviewed.

Keywords

Intervertebral disc herniation - time to ambulation - dogs

• References

• 1 Davis GJ, Brown DC. Prognostic indicators for time to ambulation after surgical decompression innon-ambulatory dogs with acute thoracolumbar disc extrusions: 112 cases. Vet Surg 2002; 31: 513-8.
• 2 Cudia SP, Duval JM. Thoracolumbar intervertebral disc disease in large, nonchondrodystrophic dogs: a retrospective study. J Am Anim Hosp Assoc 1997; 33: 456-60.
• 3 Macias C, McKee WM, May C. et al. Thoracolumbar disc disease in large dogs: a study of 99 cases. J Small Anim Pract 2002; 43: 439-46.
• 4 Duval J, Dewey C, Roberts R. et al. Spinal cord swelling as a myelographic indicator of prognosis: a retrospective study in dogs with intervertebral disc disease and loss of deep pain perception. Vet Surg 1996; 25: 6-12.
• 5 Scott HW. Hemilaminectomy for the treatment of thoracolumbar disc disease in the dog: a follow-up study of 40 cases. J Small Anim Pract 1997; 38: 488-94.
• 6 Knecht CD. Results of surgical treatment for thoracolumbar disc protrusion. J Small Anim Pract. 1972; 13: 449-53.
• 7 Ferreira AJA, Correia JHD, Jaggy A. Thoracolumbar disc disease in 71 paraplegic dogs: influence of rate of onset and duration of clinical signs on treatment results. J Small Anim Pract 2002; 43: 158-63.
• 8 Olby N, Levine J, Harris T. et al. Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001). J Am Vet Med Assoc 2003; 222: 762-9.
• 9 Dhupa S, Glickman NW, Waters DJ. Functional outcome in dogs after surgical treatment of caudal lumbar intervertebral disc herniation. J Am Anim Hosp Assoc 1999; 35: 323-31.
• 10 Toombs JP, Waters DJ. Intervertebral disc disease. In: Textbook of Small Animal Surgery. Slatter DH. (ed) Philadelphia: Saunders; 2002: 1202-3.
• 11 Braund KG. Acute spinal cord trauma. In: Disease mechanisms in small animal surgery. Bojrab JM. (ed) Philadelphia: Leaand Febiger; 1993: 1146-9.
• 12 Dohoo I, Martin W, Henrik S. Veterinary Epidemiologic research. Charlottetown, Prince Edward Island, Canada, 2003; 409-57.
• 13 SPSS Inc. SPSS AdvancedModels, Release 10.0. SPSS Inc. 1999. Chicago, IL.:
• 14 Scott HW, McKee WM. Laminectomy for 34 dogs with thoracolumbar intervertebral disc disease and loss of deep pain perception. J Small Anim Pract 1999; 40: 417-22.
• 15 Dhupa S, Glickman N, Waters DJ. Reoperative neurosurgery in dogs with thoracolumbar disc disease. Vet Surg 1999; 28: 421-8.