Acute Spinal Cord Injury

Granger, Nicolas; Carwardine, Darren

doi:10.1016/j.cvsm.2014.07.013

Cited by 47 publications

(19 citation statements)

References 137 publications

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“…This information will be useful for the planning of future studies using dogs with clinical SCI and suggests that a proportion of dogs (15%) are presented within the peracute (<8 hours) window that may be required for studies targeting acute neuroprotection. One caveat to this finding is that two institutions entering cases into the database during the study period were conducting veterinary clinical trials in SCI, which may have encouraged early referral of cases to their facility and influencing the number of cases presenting acutely and with more severe injuries; however, the apparent prevalence of sensorimotor complete injuries in the current study is similar to what has been reported in other studies [ 40 ]. Accrual of additional cases from multiple institutions will be necessary to fully evaluate the proportion of dogs with acute, subacute, and chronic timing of presentation that may be available for clinical trials; however, preliminary data suggests that efficient acute neuroprotective studies should be feasible when a multi-institutional approach is used.…”

Section: Discussionsupporting

confidence: 69%

“…The most common cause of SCI in dogs in the current study was IVDH-associated SCI which accounted for all but three of the cases entered in the CSCI. This is reflective, in part, of the fact that IVDH-associated SCI is noted to be the most common cause of SCI in dogs [ 39 , 40 ]. The prevalence of other causes of SCI such as ischemic myelopathy and extrinsic trauma causing vertebral fracture/luxation is likely falsely low in the reported cohort of dogs because initial efforts related to the database focused only on accrual of IVDH cases.…”

Section: Discussionmentioning

confidence: 99%

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Development of an International Canine Spinal Cord Injury observational registry: a collaborative data-sharing network to optimize translational studies of SCI

Moore

Zidan

Spitzbarth³

et al. 2018

Spinal Cord

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Study Design Prospective cross sectional cohort study Objectives The canine spontaneous model of spinal cord injury (SCI) is as an important pre-clinical platform as it recapitulates key facets of human injury in a naturally occurring context. The establishment of an observational canine SCI registry constitutes a key step in performing epidemiologic studies and assessing the impact of therapeutic strategies to enhance translational research. Further, accumulating information on dogs with SCI may contribute to current “big data” approaches to enhance understanding of the disease using heterogeneous multi-institutional, multi-species data sets from both pre-clinical and human studies. Setting Multiple veterinary academic institutions across the United States and Europe. Methods Common data elements recommended for experimental and human SCI studies were reviewed and adapted for use in a web-based registry, to which all dogs presenting to member veterinary tertiary care facilities were prospectively entered over approximately one year. Results Analysis of data accumulated during the first year of the registry suggests that 16% of dogs with SCI present with severe, sensorimotor complete, injury and that 15% of cases are seen by a tertiary care facility within 8 hours of injury. Similar to the human SCI population, 34% were either overweight or obese. Conclusions Severity of injury and timing of presentation suggests that neuroprotective studies using the canine clinical model could be conducted efficiently using a multi-institutional approach. Additionally, pet dogs with SCI experience similar comorbidities to people with SCI, in particular obesity, and could serve as an important model to evaluate the effects of this condition.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Development of an International Canine Spinal Cord Injury observational registry: a collaborative data-sharing network to optimize translational studies of SCI

Moore

Zidan

Spitzbarth³

et al. 2018

Spinal Cord

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“…The main impetus that drives the perceived need for a new therapy for spinal cord injury in dogs is the lower proportion of dogs that recover locomotion (and other functions) after presenting with loss of “deep pain sensation” following acute thoracolumbar intervertebral disc herniation. In this sub-group, the proportion that recover independent quadrupedal locomotion is usually estimated to be around 55%, in contrast to the estimated 90–95% recovery for dogs that present with “deep pain sensation” intact ( 6 , 10 , 11 ). Furthermore, most of these deep pain negative dogs do not recover appropriate autonomic function either.…”

Section: Selection Of Casesmentioning

confidence: 91%

“…Although there is much to be learned about how best to treat dogs with spinal cord injuries of all types, those that have incurred acute thoracolumbar disc herniation are most in need of new therapies. This is partly because it is the most common type of injury ( 8 ), and partly because there is a recognized poor prognosis for dogs in some sub-categories of this cohort ( 9 , 10 ). The main impetus that drives the perceived need for a new therapy for spinal cord injury in dogs is the lower proportion of dogs that recover locomotion (and other functions) after presenting with loss of “deep pain sensation” following acute thoracolumbar intervertebral disc herniation.…”

Section: Selection Of Casesmentioning

confidence: 99%

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

2020

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There is a clear need for new methods of treatment of acute disc herniation in dogs, most obviously to address the permanent loss of function that can arise because of the associated spinal cord injury. Clinical trials form the optimal method to introduce new therapies into everyday clinical practice because they are a reliable source of unbiased evidence of effectiveness. Although many designs are available, parallel cohort trials are most widely applicable to acute disc herniation in dogs. In this review another key trial design decision—that between pragmatic and explanatory approaches—is highlighted and used as a theme to illustrate the close relationship between trial objective and design. Acute disc herniation, and acute spinal cord injury, is common in dogs and there is a multitude of candidate interventions that could be trialed. Most current obstacles to large-scale clinical trials in dogs can be overcome by collaboration and cooperation amongst interested veterinarians.

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“…Acute thoracolumbar intervertebral disk extrusion (IVDE) is the most common cause of acute spinal cord injury (SCI) in dogs and can cause death or permanent disability in affected dogs 1, 2. Treatment can be medical or surgical, with the decision to perform surgery based on clinical factors such as the severity and rate of progression of neurological deficits 3, 4, 5, 6, 7.…”

mentioning

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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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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Acute Spinal Cord Injury

Cited by 47 publications

References 137 publications

Development of an International Canine Spinal Cord Injury observational registry: a collaborative data-sharing network to optimize translational studies of SCI

Development of an International Canine Spinal Cord Injury observational registry: a collaborative data-sharing network to optimize translational studies of SCI

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

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

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