Prevalence and Risk Factors for Presumptive Ascending/Descending Myelomalacia in Dogs after Thoracolumbar Intervertebral Disk Herniation
Prevalence and Risk Factors for Presumptive Ascending/Descending Myelomalacia in Dogs after Thoracolumbar Intervertebral Disk Herniation
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DOI：
10.1111/jvim.14656
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发表时间：
2017-03-01
影响因子：
2.6
通讯作者：
Bernardini, M.
中科院分区：
文献类型：
--
作者：
Balducci, F.;Canal, S.;Bernardini, M.
背景：升/降髓软化(ADMM)是犬胸腰椎间盘突出症(TL-IVDH)的严重并发症。方法：回顾2007年2月至2015年12月的病历。结果：13只犬患多发性骨髓瘤，总患病率为2.0%。在入院时或在磁共振成像(MRI)或手术前神经体征为1级或2级的狗中，ADMM的患病率为0%，在神经体征为3级的狗中为0.6%，在神经体征为4级的狗中为2.7%，在神经体征为5级的狗中为14.5%。年龄(5.8岁)，神经状况(5级)，腰椎间盘突出的位置(L5-L6)，临床体征变为不可活动的时间(<；24小时)，髓内T2加权(T2W)高信号的检测，以及T2长度比和GT；4.57是ADMM发生的单因素分析中的显著危险因素。结论和临床意义：本研究确定的因素可能有助于ADMM的预测。需要对更多患有ADMM的狗进行多中心研究来证实这些数据。
Background: Ascending/descending myelomalacia (ADMM) is a severe complication of thoracolumbar intervertebral disk herniation (TL-IVDH) in dogs.Hypothesis/Objectives: To investigate the prevalence and risk factors for ADMM in nonambulatory dogs with surgically treated TL-IVDH. Animals: Six-hundred and fifty-two client-owned dogs evaluated for TL-IVDH that underwent decompressive spinal surgery.Methods: Retrospective medical record review from February 2007 through December 2015.Results: Thirteen dogs developed ADMM, with an overall prevalence of 2.0%. The prevalence of ADMM was 0% in dogs with neurological signs graded 1 or 2 at admission or before magnetic resonance imaging (MRI) or surgical procedures, 0.6% in dogs with neurological signs graded 3, 2.7% in dogs with neurological signs graded 4, and 14.5% in dogs with neurological signs graded 5. Age (< 5.8 years), neurological status (grade 5), site of disk herniation (L5-L6), duration of clinical signs before becoming nonambulatory (< 24 hours), detection of intramedullary T2-weighted (T2W) hyperintensity, and a T2 length ratio > 4.57 were significant risk factors in the univariate analysis for development of ADMM.Conclusions and Clinical Importance: The factors identified in this study may be useful for the prediction of ADMM. Multicenter studies with a higher number of dogs with ADMM are required to confirm these data.