Prognostic value of magnetic resonance imaging in dogs with paraplegia caused by thoracolumbar intervertebral disk extrusion: 77 cases (2000–2003)

Ito, Daisuke; Matsunaga, Satoru; Jeffery, Nick D.; Sasaki, Nobuo; Nishimura, Ryohei; Mochizuki, Manabu; Kasahara, Mihoko; Fujiwara, Ryo; Ogawa, Hiroyuki

doi:10.2460/javma.2005.227.1454

Cited by 143 publications

(216 citation statements)

References 34 publications

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“…Consistent with previous studies,11, 12, 13, 14, 15, 41, 42 45.7% of grade 5 dogs became ambulatory within 6 weeks, compared with 100% of grade 3 and 4 dogs. While the regression tree for the OFS outcome measure revealed conflicting effects of total duration of anesthesia in a small subgroup (Fig 1), considering the similar findings in the regression tree analysis for ambulatory status (Fig 3) as well as the final general linear and ridge regression models, the predominant relationship identified in grade 5 dogs was a poorer outcome with increased duration of surgery (Figs 1, 3; Tables 3, 5).…”

Section: Discussionsupporting

confidence: 90%

“…Another limitation of the current study is the lack of longer term follow‐up data beyond 6 weeks postoperatively, as some dogs that were nonambulatory at 6 weeks could have gone on to recover ambulatory function in the longer term. However, previous studies have shown that the majority of postoperative functional recovery after SCI in dogs occurs within 4–8 weeks of surgery, supporting this observation time frame 11, 13, 32, 42. To maximize the outcome data available, we used 2 functional scoring systems postsurgery; an ordinal 12‐point score (OFS) and a treadmill‐based gait score (RI), both described and validated previously 31, 35.…”

Section: Discussionmentioning

confidence: 78%

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Associations Between Anesthetic Variables and Functional Outcome in Dogs With Thoracolumbar Intervertebral Disk Extrusion Undergoing Decompressive Hemilaminectomy

Fenn

Laber

Williams

et al. 2017

Veterinary Internal Medicne

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BackgroundOutcome of acute experimental spinal cord injury is strongly associated with tissue perfusion and oxygenation. Cardiopulmonary depression could affect outcome in dogs undergoing general anesthesia for surgical treatment of thoracolumbar intervertebral disk extrusion (IVDE).Hypothesis/ObjectivesTo evaluate the effects of general anesthesia on functional outcome in dogs undergoing surgery to treat thoracolumbar IVDE.AnimalsEighty‐four client‐owned dogs with acute thoracolumbar IVDE treated by decompressive hemilaminectomy.MethodsExploratory, retrospective observational study. Medical records were reviewed for clinical presentation and anesthetic monitoring variables, including duration of anesthesia and surgery, hypotension, bradycardia, temperature, and respiratory parameters. Multivariable regression tree analysis was performed to explore associations between anesthetic variables and functional outcome scores after 6 weeks, as well as return to ambulatory status.ResultsEpisodes of bradycardia (69%) and hypotension (57%) were frequent. Across all outcome measures, regression tree analysis highlighted functional grade at presentation as the primary determining factor, and among pain perception negative dogs, there was a possible association between increased duration of surgery and poorer outcome. In dogs with intact pain perception, duration of bradycardia, mean body temperature, and mean end‐tidal carbon dioxide were highlighted.Conclusions and Clinical ImportanceExploratory statistical methods can facilitate hypothesis‐generating studies to inform prospective investigations in veterinary medicine. Although the mechanism is uncertain, increased duration of surgery might be associated with poorer outcome in pain perception negative dogs with thoracolumbar IVDE.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 78%

Associations Between Anesthetic Variables and Functional Outcome in Dogs With Thoracolumbar Intervertebral Disk Extrusion Undergoing Decompressive Hemilaminectomy

Fenn

Laber

Williams

et al. 2017

Veterinary Internal Medicne

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“…Evaluation of DPP and length of intramedullary hyperintense signal in sagittal T2‐weighted MRI were proven to be useful predictive tools for long‐term MFR 2, 18, 21, 23…”

mentioning

confidence: 99%

Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs with Intervertebral Disk Herniations

Wang‐Leandro

Siedenburg

Hobert

et al. 2017

Veterinary Internal Medicne

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BackgroundPrognostic tools to predict early postoperative motor function recovery (MFR) after thoracolumbar intervertebral disk herniation (IVDH) in paraplegic dogs represent an opportunity to timely implement novel therapies that could shorten recovery times and diminish permanent neurological dysfunctions.HypothesisFractional anisotropy (FA) values obtained using diffusion tensor imaging have a higher prognostic value than a lesion extension ratio in T2‐weighted images (T2W‐LER) and clinical assessment of deep pain perception (DPP) for MFR.AnimalsThirty‐five paraplegic dogs with diagnosis of acute or subacute thoracolumbar IVDH.MethodsProspective, descriptive observational study. At admission, absence or presence of DPP, T2W‐LER, and FA values was evaluated. MFR was assessed within 4 weeks after decompressive surgery. Values of T2W‐LER and FA of dogs with and without MFR were compared using t‐tests. All 3 methods were evaluated for their sensitivity and specificity as a prognostic factor.ResultsNo differences were found between groups regarding T2W‐LER. FA values differed statistically when measured caudally of lesion epicenter being higher in dogs without MFR compared to dogs with MFR (P = .023). Logistic regression analysis revealed significance in FA values measured caudally of the lesion epicenter (P = .033, area under the curve = 0.72). Using a cutoff value of FA = 0.660, the technique had a sensitivity of 80% and a specificity of 55%. Evaluation of DPP had a sensitivity of 73.3% and specificity of 75% (P = .007).Conclusions and Clinical ImportanceEvaluation of DPP showed a similar sensitivity and a better specificity predicting early MFR than quantitative magnetic resonance imaging.

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“…74 Conversely, the loss of pain sensation to the pelvic limbs is always associated with a worse prognosis: in association with fracture-luxations, it immediately indicates a very poor, or hopeless, prognosis; after disc extrusionrelated cord contusion-compression lesions, it indicates a poor to hopeless prognosis if still absent by B6 weeks after the initiating incident. 73 This is a patient population analogous to the population of human patients for which novel therapies would initially be targeted.…”

Section: Predicting Outcomementioning

confidence: 99%

“…Fortunately, there is an easily identifiable group of such patients within the population of spinal cord injured dogs; B50% of those that suffer acute SCI as a result of extrusion of an intervertebral disc and lose all motor and sensory function to the pelvic limbs will recover the ability to walk. 73,74,91 There will always be variability in the recovery rate after clinical SCI, owing to variability in the nature of the injury -even within defined severity groups -meaning that power calculations are required to optimise the experimental design. Depending on the study population, widely varying numbers of dogs might be required.…”

Section: Patient Selectionmentioning

confidence: 99%

Clinical canine spinal cord injury provides an opportunity to examine the issues in translating laboratory techniques into practical therapy

et al. 2006

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Study design: Review. Objectives: To highlight the value of investigating the effects of putative therapeutic interventions in clinical spinal cord injury (SCI) in domestic dogs. Setting: England, UK. Methods: Many experimental interventions in laboratory rodents have been shown to ameliorate the functional deficits caused by SCI; the challenge now is to determine whether they can be translated into useful clinical techniques. Important differences between clinical SCI in human patients and that in laboratory rodents are in the size of the spinal cord and heterogeneity of injury severity. A further key issue is whether the statistical difference in outcome in the laboratory will translate into a useful difference in clinical outcome. Here, we stress the value of investigating the effects of putative therapies in clinical SCI in domestic dogs. The causes of injury, ability to categorise the severity and methods available to measure outcome are very similar between canine and human patients. Furthermore, postmortem tissue more rapidly becomes available from dogs because of their short lifespan than from human patients. Results: The role that investigation of canine SCI might play is illustrated by our preliminary trials on intraspinal transplantation of olfactory glial cells for severe SCI. Conclusions: This canine translational model provides a means of 'filtering' putative treatments before human application.

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Prognostic value of magnetic resonance imaging in dogs with paraplegia caused by thoracolumbar intervertebral disk extrusion: 77 cases (2000–2003)

Abstract: Findings suggest that results of magnetic resonance imaging can be used to predict clinical outcome in dogs with paraplegia caused by intervertebral disk extrusion.

Cited by 143 publications

References 34 publications

Associations Between Anesthetic Variables and Functional Outcome in Dogs With Thoracolumbar Intervertebral Disk Extrusion Undergoing Decompressive Hemilaminectomy

Associations Between Anesthetic Variables and Functional Outcome in Dogs With Thoracolumbar Intervertebral Disk Extrusion Undergoing Decompressive Hemilaminectomy

Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs with Intervertebral Disk Herniations

Clinical canine spinal cord injury provides an opportunity to examine the issues in translating laboratory techniques into practical therapy

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