Fecal incontinence associated with epidural spinal hematoma and intervertebral disk extrusion in a dog
Fecal incontinence associated with epidural spinal hematoma and intervertebral disk extrusion in a dog
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DOI：
10.2460/javma.228.2.230
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发表时间：
2006-01-15
影响因子：
1.9
通讯作者：
Olby, NJ
中科院分区：
文献类型：
--
作者：
Cerda-Gonzalez, S;Olby, NJ
病例描述：一名7岁的阉割雄性大丹犬因2个月的大便失禁史而被评估。临床表现：在出现麻痹和脊髓反射明显正常的基础上，神经系统体征局限于第三胸至第三腰椎节段区域。根据磁共振成像结果，推定诊断为椎间盘压缩性挤压伴继发性出血和硬膜外血肿形成。治疗和结果：行右侧半椎板切除术（以T13-L1椎间隙为中心）以进一步确定病变特征并对脊髓进行减压。组织病理学诊断为椎间盘突出物伴慢性出血和炎症。手术后三周，狗的大便失禁完全消失，后肢功能有中度改善。临床意义-胸腰椎脊髓损伤可导致行走犬的上运动神经元大便失禁，硬膜外脊髓血肿可继发于椎间盘突出，造成脊髓压迫，导致神经功能缺损。
Case Description-A 7-year-old castrated male Great Dane was evaluated because of a 2-month history of fecal incontinence.Clinical Findings-On the basis of the presence of paraparesis and apparently normal spinal reflexes, the neurologic signs were localized in the region of the third thoracic to the third lumbar spinal cord segments. On the basis of the findings of magnetic resonance imaging, a presumptive diagnosis of a compressive intervertebral disk extrusion with secondary hemorrhage and epidural hematoma formation was made.Treatment and Outcome-A right-sided hemilaminectomy was performed (centered at the T13-L1 intervertebral space) to further characterize the lesion and decompress the spinal cord. The histopathologic diagnosis was extruded intervertebral disk material with chronic hemorrhage and inflammation. Three weeks after surgery, there was complete resolution of the dog's fecal incontinence and moderate improvements in its hind limb function.Clinical Relevance-Thoracolumbar spinal cord injuries can result in upper motor neuron fecal incontinence in ambulatory dogs, Epidural spinal hematomas may develop secondary to intervertebral disk herniations and cause spinal cord compression resulting in neurologic deficits.