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Vet Comp Orthop Traumatol 2023; 36(06): 287-293
DOI: 10.1055/s-0043-1770355
Original Research

Thoracolumbar Intervertebral Disk Extrusion in Dogs: Do Onset of Clinical Signs, Time of Surgery, and Neurological Grade Matter?

Krizia Compagnone 
1   Northwest Veterinary Specialists, Delamere House, Ashville Point, Sutton Weaver, Runcorn, United Kingdom
,
David A. Upchurch
2   Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, United States
,
Elisa Pompermaier
3   Wear Referrals Veterinary Specialist & Emergency Hospital, Bradbury, Stockton-on-Tees TS21 2ES, United Kingdom
,
Luca Motta
1   Northwest Veterinary Specialists, Delamere House, Ashville Point, Sutton Weaver, Runcorn, United Kingdom
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Abstract

Objective The aim of this study was to determine the influence of time between the beginning of clinical signs, presentation and decompression, and combinations of several factors on the outcome and recovery of dogs undergoing surgery for thoracolumbar intervertebral disk extrusion (IVDE).

Study Design In all, 433 client-owned dogs treated for IVDE between 2016 and 2020 were reviewed for signalment, neurological grade, rate of onset, duration of clinical signs, and surgical variables. Time from presentation to surgery was divided into three categories: S1 (0–12 hours), S2 (12–24 hours), and S3 (>24 hours). These variables were investigated to determine their influence on the return of pain sensation, urinary continence, ambulation and overall outcome.

Results A significant association was found between an acute onset of clinical signs, worse neurological grade at presentation and poorer outcomes. There was a significant difference between S1, S2, and S3 in neurological grade at presentation (p < 0.001) and at discharge (p < 0.001); however, the latter was no longer significant when adjusted for the grade at presentation (p = 1,000). Disk fenestration was associated with a faster return to ambulation (p = 0.033). Duration of clinical signs and time of surgery did not correlate with the time to recovery and return of pain sensation, urinary continence, or ambulation.

Conclusion Dogs presented with severe neurological status and/or rapid onset of clinical signs were operated on more promptly, but their outcomes were also poorer. There was no significant evidence for a better outcome when surgery was not delayed.

Keywords

neurosurgery - spinal disk disease - spine surgery - IVDE - intervertebral disk disease

Authors' Contribution

K.C. contributed to conception and study design, acquisition of data, data analysis and interpretation, and writing of the draft. D.A.U. contributed to study design, acquisition of data, and data analysis and interpretation. E.P. contributed to acquisition of data and data analysis and interpretation. L.M. contributed to conception and study design, and data analysis and interpretation. All the authors reviewed, revised, and approved the submitted manuscript.




Publication History

Received: 25 February 2022

Accepted: 23 May 2023

Article published online:
05 July 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Davis GJ, Brown DC. Prognostic indicators for time to ambulation after surgical decompression in nonambulatory dogs with acute thoracolumbar disk extrusions: 112 cases. Vet Surg 2002; 31 (06) 513-518
    CrossrefPubMedGoogle Scholar
  • 2 Macias C, Mckee WM, May C, Innes JF. Thoracolumbar disc disease in large dogs: a study of 99 cases. J Small Anim Pract 2002; 43 (10) 439-446
    CrossrefPubMedGoogle Scholar
  • 3 Ferreira AJ, Correia JH, 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 (04) 158-163
    CrossrefPubMedGoogle Scholar
  • 4 Olby N, Levine J, Harris T, Muñana K, Skeen T, Sharp N. 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 (06) 762-769
    CrossrefPubMedGoogle Scholar
  • 5 Ruddle TL, Allen DA, Schertel ER. et al. Outcome and prognostic factors in non-ambulatory Hansen type I intervertebral disc extrusions: 308 cases. Vet Comp Orthop Traumatol 2006; 19 (01) 29-34
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 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 (09) 417-422
    CrossrefPubMedGoogle Scholar
  • 7 Levine JM, Levine GJ, Johnson SI, Kerwin SC, Hettlich BF, Fosgate GT. Evaluation of the success of medical management for presumptive thoracolumbar intervertebral disk herniation in dogs. Vet Surg 2007; 36 (05) 482-491
    CrossrefPubMedGoogle Scholar
  • 8 Davies JV, Sharp NJH. A comparison of conservative treatment and fenestration for thoracolumbar intervertebral disc disease in the dog. J Small Anim Pract 1983; 24: 721-729
    CrossrefPubMedGoogle Scholar
  • 9 Brown NO, Helphrey M, Prata R. Thoracolumbar disk disease in the dog: a retrospective analysis of 187 cases. J Am Anim Hosp Assoc 1977; 13: 665-672
    PubMedGoogle Scholar
  • 10 Langerhuus L, Miles J. Proportion recovery and times to ambulation for non-ambulatory dogs with thoracolumbar disc extrusions treated with hemilaminectomy or conservative treatment: a systematic review and meta-analysis of case-series studies. Vet J 2017; 220: 7-16
    CrossrefPubMedGoogle Scholar
  • 11 Olby NJ, Moore SA, Brisson B. et al. ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion. J Vet Intern Med 2022; 36 (05) 1570-1596
    CrossrefPubMedGoogle Scholar
  • 12 Shaw TA, De Risio L, Laws EJ, Rose JH, Harcourt-Brown TR, Granger N. Prognostic factors associated with recovery of ambulation and urinary continence in dogs with acute lumbosacral spinal cord injury. J Vet Intern Med 2017; 31 (03) 825-831
    CrossrefPubMedGoogle Scholar
  • 13 Duval J, Dewey C, Roberts R, Aron D. 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 (01) 6-12
    CrossrefPubMedGoogle Scholar
  • 14 Ito D, Matsunaga S, Jeffery ND. et al. Prognostic value of magnetic resonance imaging in dogs with paraplegia caused by thoracolumbar intervertebral disk extrusion: 77 cases (2000-2003). J Am Vet Med Assoc 2005; 227 (09) 1454-1460
    CrossrefPubMedGoogle Scholar
  • 15 Bergman R, Lanz O, Shell L. Acute spinal cord trauma: mechanisms and clinical syndromes. Vet Med 2000; 95 (11) 846-849
    PubMedGoogle Scholar
  • 16 Gambardella PC. Dorsal decompressive laminectomy for treatment of thoracolumbar disk disease in dogs: a retrospective study of 98 cases. Vet Surg 1980; 9 (01) 24-26
    CrossrefPubMedGoogle Scholar
  • 17 Skytte D, Schmökel H. Relationship of preoperative neurologic score with intervals to regaining micturition and ambulation following surgical treatment of thoracolumbar disk herniation in dogs. J Am Vet Med Assoc 2018; 253 (02) 196-200
    CrossrefPubMedGoogle Scholar
  • 18 Kazakos G, Polizopoulou ZS, Patsikas MN, Tsimopoulos G, Roubies N, Dessiris A. Duration and severity of clinical signs as prognostic indicators in 30 dogs with thoracolumbar disk disease after surgical decompression. J Vet Med A Physiol Pathol Clin Med 2005; 52 (03) 147-152
    CrossrefPubMedGoogle Scholar
  • 19 Bull C, Fehr M, Tipold A. Canine intervertebral disk disease: a retrospective study of clinical outcome in 238 dogs (2003-2004). Berl Munch Tierarztl Wochenschr 2008; 121 (3–4): 159-170
    PubMedGoogle Scholar
  • 20 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 (11) 488-494
    CrossrefPubMedGoogle Scholar
  • 21 Upchurch DA, Renberg WC, Turner HS, McLellan JG. Effect of duration and onset of clinical signs on short-term outcome of dogs with Hansen type I thoracolumbar intervertebral disc extrusion. Vet Comp Orthop Traumatol 2020; 33 (03) 161-166
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Vincens Zanoguera L, Pauciulo C. et al. Does surgical timing affect the rapidity of recovery in deep pain-entire non-ambulatory dogs with thoracolumbar intervertebral disk extrusion?. J Small Anim Pract 2022
    PubMedGoogle Scholar
  • 23 Osterholm JL. The pathophysiological response to spinal cord injury. The current status of related research. J Neurosurg 1974; 40 (01) 5-33
    CrossrefPubMedGoogle Scholar
  • 24 Ducker TB, Kindt GW, Kempf LG. Pathological findings in acute experimental spinal cord trauma. J Neurosurg 1971; 35 (06) 700-708
    CrossrefPubMedGoogle Scholar
  • 25 Jeffery ND, Barker AK, Hu HZ. et al. Factors associated with recovery from paraplegia in dogs with loss of pain perception in the pelvic limbs following intervertebral disk herniation. J Am Vet Med Assoc 2016; 248 (04) 386-394
    CrossrefPubMedGoogle Scholar
  • 26 Ingram EA, Kale DC, Balfour RJ. Hemilaminectomy for thoracolumbar Hansen Type I intervertebral disk disease in ambulatory dogs with or without neurologic deficits: 39 cases (2008-2010). Vet Surg 2013; 42 (08) 924-931
    CrossrefPubMedGoogle Scholar
  • 27 Immekeppel A, Rupp S, Demierre S. et al. Investigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion: a retrospective study of 1501 cases. Acta Vet Scand 2021; 63 (01) 30
    CrossrefPubMedGoogle Scholar
  • 28 Levine JM, Levine GJ, Kerwin SC, Hettlich BF, Fosgate GT. Association between various physical factors and acute thoracolumbar intervertebral disk extrusion or protrusion in Dachshunds. J Am Vet Med Assoc 2006; 229 (03) 370-375
    CrossrefPubMedGoogle Scholar
  • 29 Levine JM, Ruaux CG, Bergman RL, Coates JR, Steiner JM, Williams DA. Matrix metalloproteinase-9 activity in the cerebrospinal fluid and serum of dogs with acute spinal cord trauma from intervertebral disk disease. Am J Vet Res 2006; 67 (02) 283-287
    CrossrefPubMedGoogle Scholar
  • 30 Cohen J. A power primer. Psychol Bull 1992; 112 (01) 155-159
    CrossrefPubMedGoogle Scholar
  • 31 Martin S, Liebel FX, Fadda A, Lazzerini K, Harcourt-Brown T. Same-day surgery may reduce the risk of losing pain perception in dogs with thoracolumbar disc extrusion. J Small Anim Pract 2020; 61 (07) 442-448
    CrossrefPubMedGoogle Scholar
  • 32 De Risio L, Muñana K, Murray M, Olby N, Sharp NJ, Cuddon P. Dorsal laminectomy for caudal cervical spondylomyelopathy: postoperative recovery and long-term follow-up in 20 dogs. Vet Surg 2002; 31 (05) 418-427
    CrossrefPubMedGoogle Scholar
  • 33 Amsellem PN, Toombs JP, Laverty PH, Breur GJ. Loss of deep pain sensation following thoracolumbar intervertebral disc herniation in dogs: treatment and prognosis. Compend Contin Educ Pract Vet 2003; 25: 266-274
    PubMedGoogle Scholar
  • 34 Rossmeisl Jr JH, White C, Pancotto TE, Bays A, Henao-Guerrero PN. Acute adverse events associated with ventral slot decompression in 546 dogs with cervical intervertebral disc disease. Vet Surg 2013; 42 (07) 795-806
    CrossrefPubMedGoogle Scholar
  • 35 Stigen Ø, Ottesen N, Jäderlund KH. Early recurrence of thoracolumbar intervertebral disc extrusion after surgical decompression: a report of three cases. Acta Vet Scand 2010; 52 (01) 10
    CrossrefPubMedGoogle Scholar
  • 36 Forterre F, Konar M, Spreng D, Jaggy A, Lang J. Influence of intervertebral disc fenestration at the herniation site in association with hemilaminectomy on recurrence in chondrodystrophic dogs with thoracolumbar disc disease: a prospective MRI study. Vet Surg 2008; 37 (04) 399-405
    CrossrefPubMedGoogle Scholar
  • 37 Brisson BA, Moffatt SL, Swayne SL, Parent JM. Recurrence of thoracolumbar intervertebral disk extrusion in chondrodystrophic dogs after surgical decompression with or without prophylactic fenestration: 265 cases (1995-1999). J Am Vet Med Assoc 2004; 224 (11) 1808-1814
    CrossrefPubMedGoogle Scholar
  • 38 Dhupa S, Glickman N, Waters DJ. Reoperative neurosurgery in dogs with thoracolumbar disc disease. Vet Surg 1999; 28 (06) 421-428
    CrossrefPubMedGoogle Scholar
  • 39 Fenn J, Olby NJ. Canine Spinal Cord Injury Consortium (CANSORT-SCI). Classification of intervertebral disc disease. Front Vet Sci 2020; 7: 579025
    CrossrefPubMedGoogle Scholar
  • 40 Pontikaki AE, Pavlidou K, Polizopoulou Z, Savvas I, Kazakos G. Prophylactic effect of fenestration on the recurrence of thoracolumbar intervertebral disc disease in dogs. Animals (Basel) 2022; 12 (19) 2601
    CrossrefPubMedGoogle Scholar