Comparison of medical and surgical treatment for acute cervical compressive hydrated nucleus pulposus extrusion in dogs

Abstract

This is the peer-reviewed, manuscript version of an article published in Veterinary Record. The final version is available online via http://dx.doi.org/10.1136/vr.104528.The full details of the published version of the article are as follows: TITLE: Comparison of medical and surgical treatment for acute cervical compressive hydrated nucleus pulposus extrusion in dogs AUTHORS: Borlace, T., Gutierrez-Quintana, R., Taylor clinical presentation, or imaging findings between both groups. Two dogs in the medically 30 managed group underwent surgical decompression due to an unsatisfactory response to 31 medical management. All cases for which long-term information was available (n=30) were 32 neurologically normal at the time of data collection. There were no significant differences for 33 any of the short or long-term outcome variables between both treatment groups. This study 34 demonstrated successful outcomes after medical or surgical treatment and suggests that both 35 treatment modalities can be considered for dogs with cervical HNPE. 36 37

Comparison of surgical and conservative treatment of hydrated nucleus pulposus extrusion in dogs

“…In general, outcome after conservative treatment of nonambulatory dogs with cervical IVDH type I is thought to be much less favorable than in dogs with thoracolumbar IVDH . Data on HNPE so far show similar or slightly superior results: 28.6%‐100% of dogs regained functional recovery after decompressive surgery within 7 days whereas the reports of HNPE treated conservatively suggest a similar favorable prognosis with 80%‐100% of the reported cases regaining functional recovery within 7 days …”

“…Until 2017, no clear recommendation on treatment of HNPE could be made, because comparative studies evaluating surgical and conservative management have been lacking. A recent study was the first that clearly opposed the predominant reports favoring surgical treatment in HNPE . The study stated, that there was no significant difference in outcome between surgical and conservative management of HNPE.…”

“…At the time of our study, no evidence supported surgery over conservative management in dogs with HNPE. Recently, another group published a similar study . They could show no significant differences for short‐term or long‐term outcome between surgical and conservative treatment of HNPE in dogs.…”

Classification of Intervertebral Disc Disease

“…This term refers to a subtype of acute herniation of a volume of partially or non-degenerate nucleus pulposus that results in a varying degree of extradural spinal cord compression ( 20 ). Whilst the condition has been referred to as “acute compressive HNPE” to signify this compression ( 84 ), it is typically referred to by the shortened initialism of HNPE ( Table 2 ). As with ANNPE, there has been variation in the terminology used to describe this presentation, with initial reports of dogs with similar clinical and diagnostic imaging findings using terms “intraspinal cyst” and “canine discal cyst” ( 86 , 87 , 132 ).…”

Acute Herniation of Nondegenerate Nucleus Pulposus

“…All dogs for which long-term outcome was available had experienced an excellent neurological recovery and no significant differences in short -and long-term outcome variables were seen between dogs treated surgically or medically for cervical HNPE. 41 The extruded material has the typical bilobed or 'seagull' appearance (arrows).…”