Extended durotomy to treat severe spinal cord injury after acute thoracolumbar disc herniation in dogs

Abstract

The Infectious Diseases Data Observatory (IDDO, https://www.iddo.org) has launched a clinical data platform for the collation, curation, standardisation and reuse of individual participant data (IPD) on treatments for two of the most globally important neglected tropical diseases (NTDs), schistosomiasis (SCH) and soiltransmitted helminthiases (STHs). This initiative aims to harness the power of data-sharing by facilitating collaborative joint analyses of pooled datasets to generate robust evidence on the efficacy and safety of anthelminthic treatment regimens. A crucial component of this endeavour has been the development of a Research Agenda to

Outcomes of extensive hemilaminectomy with durotomy on dogs with presumptive progressive myelomalacia: a retrospective study on 34 cases

“…Therefore, we hypothesized that extensive incision of the dura mater and hemilaminectomy in dogs with PMM could reduce intramedullary pressure. It was already observed that decompression with durotomy is possibly an effective treatment for recovering ambulation in severe acute IVDH [18,19]. These studies showed that durotomy in combination with decompression could potentially prevent the development of PMM in dogs with IVHD with NDPP of the pelvic limbs [18,19].…”

“…The extend of hemilaminectomy and durotomy should be carefully considered. A previous study showed that the durotomy extending for four vertebral lengths improved functional outcome in dogs with severe spinal cord injury after acute IVDH [18]. Selection of this length was based on previous studies on the length of spinal cord swelling estimated from imaging findings [14,29].…”

“…Both durotomy and extended thoracolumbar durotomy were previously shown to improve the rate of regaining ambulation in dogs with IVDH and NDPP in the pelvic limbs [18,19]. The improved outcome after durotomy or extensive durotomy seemed to result from physical decompression of the spinal cord [18,19]. Additionally, performing durotomy seemed to prevent the development of PMM in dogs with IVDH and NDPP in the pelvic limbs [19].…”

Clinical Trial Design—A Review—With Emphasis on Acute Intervertebral Disc Herniation

“…In terms of surgical interventions, there is accumulating evidence that durotomy/duroplasty may be of value in reducing the intraparenchymal spinal cord pressure (thereby improving blood flow) in humans ( 23 ), experimental animals ( 24 ) and, recently, clinical canine patients ( 25 , 26 ). This intervention has the benefit of being applicable for many hours, or even days, following an acute spinal cord injury and so could readily be translated into clinical veterinary practice.…”

“…Although there has been debate over the value of durotomy as an additional decompressive technique that might aid in restoring blood supply (and therefore retaining tissue integrity) after spinal cord injury, there are now data supporting its efficacy in clinically paralyzed dogs ( 25 , 26 ).…”