Risk factors for early post-operative neurological deterioration in dogs undergoing a cervical dorsal laminectomy or hemilaminectomy: 100 cases (2002–2014)

Taylor‐Brown, Frances; Cardy, Thomas J. A.; Liebel, Francois-Xavier; Garosi, Laurent; Kenny, Patrick; Volk, Holger A.; Decker, Steven De

doi:10.1016/j.tvjl.2015.10.010

Cited by 30 publications

(62 citation statements)

References 12 publications

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“…An increased duration of surgery could be related to a more challenging procedure, potentially due to the nature of the disk extrusion, and could therefore be directly related to the intrinsic severity of the initial contusion, cord compression, and consequent SCI. Indeed, a recent study found a small but statistically significant association between increased surgical duration and postoperative neurological deterioration in dogs undergoing potentially more complex cervical dorsal laminectomy procedures 43. In the current study, parameters that might affect surgery duration such as the number of sites surgically decompressed, and surgical expertise was not identified in the regression tree analysis as influencing outcome.…”

Section: Discussioncontrasting

confidence: 53%

“…Indeed, a recent study found a small but statistically significant association between increased surgical duration and postoperative neurological deterioration in dogs undergoing potentially more complex cervical dorsal laminectomy procedures. 43 In the current study, parameters that might affect surgery duration An estimated regression tree displaying associations between recorded variables and outcome, as measured by ambulatory status 6 weeks after hemilaminectomy to treat intervertebral disk extrusion (IVDE). The branching of the tree follows the same rules as outlined for Figure 1.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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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“…This is the first report of the C‐LOX implant used to indirectly decompress and stabilise a patient with dorsolateral spinal cord compression. Direct decompressive procedures such as a dorsal laminectomy are associated with a high morbidity . There have been recent investigations into treating OACSM with indirect decompressive techniques.…”

Section: Discussionmentioning

confidence: 99%

Surgical management and long‐term outcome of dogs with cervical spondylomyelopathy with an anchored intervertebral titanium device

Jc¹,

Corfield²,

Jg³

et al. 2020

Aust Veterinary J

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Objective To assess the short-and long-term outcome of an anchored intervertebral titanium device (C-LOX) for the treatment of 10 dogs with disc-associated cervical spondylomyelopathy (DACSM) and 1 dog with osseous-associated cervical spondylomyelopathy.Design Retrospective case series.Methods Dogs were included if they were diagnosed with either DACSM or osseous-associated cervical spondylomyelopathy via myelography with or without advanced imaging and underwent surgical distraction and stabilisation of the affected intervertebral disc with a C-LOX implant. Assessment included shortterm neurological outcome, radiography immediately and 6 weeks' postsurgery, owner questionnaire and veterinary clinical assessment.Results The mean follow-up time was 12 months. Improvement in neurological status was noted in 10 of 11 dogs. Screw loosening or subsidence occurred in five dogs. Revision surgery was performed in two dogs due to implant fracture (n = 1) and recurrence of spinal cord compression due to endplate subsidence around the implant (n = 1). Adjacent segment disease occurred in three dogs (30%) with DACSM at a mean of 11 months postsurgery. ConclusionThe use of the C-LOX implant for dogs with cervical spondylomyelopathy resulted in a high rate of initial neurological improvement; however, there is a moderate incidence of minor and major complications that is comparable to previously described distraction-stabilisation techniques.

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“…Previously described direct decompression techniques such as dorsal laminectomy and ventral slot address the static component of the disease . The rate of transient postoperative neurological deterioration after dorsal laminectomy was reported to be as high as 62%–70%, whereas distraction‐fusion techniques were associated with substantially lower morbidity rates of 0%–12% . Previously described methods used for distraction‐stabilization techniques include use of pins or screws and polymethylmethacrylate (PMMA), interbody screws, washers, novel vertebral spacer, screw bar‐PMMA, locking plates, intervertebral cage and locking plates, and distractable fusion cage .…”

Section: Introductionmentioning

confidence: 99%

Ventral distraction‐stabilization in 5 continuous sites for the treatment of cervical spondylomyelopathy in a Great Dane

Tuan¹,

Solano²,

Fitzpatrick³

2019

Veterinary Surgery

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Objective: To report the combined use of novel and commercially available implants for ventral distraction-stabilization of 5 continuous compressive sites in a Great Dane with cervical spondylomyelopathy (CSM). Study design: Case report. Animals: One 4-year-old male Great Dane weighing 78 kg. Methods: A tetraparetic 4-year-old Great Dane with osseous-associated CSM (OA-CSM) with 5 sites of dorsolateral compression was presented for surgical intervention. Custom designed Fitz intervertebral traction screws (FITS) and a commercially available polyaxial spinal system were used for ventral distraction-stabilization of all lesions. Multiple neurological reevaluations were performed, with the final evaluation at 27 months postoperatively. Preoperative, immediate-postoperative, and 27 month-postoperative computed tomography (CT) images were retrospectively reviewed to compare the vertebral canal dimensions at the affected sites. Results: Multilevel distraction-stabilization technique resulted in improvement of the dog's neurological function by 10 days postoperatively. The vertebral canal measurements were revealed to have improved in over half of the measured variables when the 27-month-postoperative images were compared with the preoperative CT images. Increased vertebral canal dimensions were observed immediately after surgery, and some of these measurements continued to improve by 27 months postoperatively. Conclusion: Ventral distraction-stabilization technique with custom-designed FITS and a polyaxial spinal system resulted in both clinical improvement and objective improvement in spinal canal measurements in an OA-CSM-affected Great Dane. Clinical significance: An indirect decompression technique can eliminate dynamic movements and result in regression of vertebral canal bony proliferation in dogs with OA-CSM.

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Risk factors for early post-operative neurological deterioration in dogs undergoing a cervical dorsal laminectomy or hemilaminectomy: 100 cases (2002–2014)

Cited by 30 publications

References 12 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

Surgical management and long‐term outcome of dogs with cervical spondylomyelopathy with an anchored intervertebral titanium device

Ventral distraction‐stabilization in 5 continuous sites for the treatment of cervical spondylomyelopathy in a Great Dane

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