Assessment of Intrathecal Pressure in Chondrodystrophic Dogs With Acute Thoracolumbar Disk Disease

Abstract

Acute thoracolumbar disk disease leads to elevated ITP in chondrodystrophic dogs, which may contribute to increased compression of spinal cord parenchyma.

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

“…The results of the current study therefore suggest that in dogs undergoing surgical decompression to treat acute thoracolumbar IVDE, a scenario whereby autoregulation of spinal cord blood flow is likely to be compromised and intrathecal pressure increased,22, 48 episodes of hypotension and bradycardia are common. Dogs undergoing longer periods of general anesthesia for more complicated surgical procedures might therefore be subjected to suboptimal spinal cord blood flow, potentially harming SCI recovery 22, 23, 48. As a result, a prospective study design utilizing frequent, direct blood pressure recordings including both extremes of fluctuation in a large number of dogs is required to further evaluate the clinical significance of blood pressure in this population of dogs.…”

“…30 It is important to consider however that perioperative hypotension might be a more clinically significant finding in cervical spinal surgery due to a greater risk of serious hemorrhage. 30,47 The results of the current study therefore suggest that in dogs undergoing surgical decompression to treat acute thoracolumbar IVDE, a scenario whereby autoregulation of spinal cord blood flow is likely to be compromised and intrathecal pressure increased, 22,48 episodes of hypotension and bradycardia are common. Dogs undergoing longer periods of general anesthesia for more complicated surgical procedures might therefore be subjected to suboptimal spinal cord blood flow, potentially harming SCI recovery.…”

“…Although the oscillometric monitor used in this study1 has previously been evaluated for validity with encouraging results,53 this method does reduce the accuracy of measurements when compared to direct arterial measurement and the results should be considered in light of this. Future studies could therefore better evaluate associations between hemodynamic anesthetic variables and long‐term outcome by utilizing more consistent techniques for prospectively monitoring intraoperative systemic perfusion parameters, such as continuously recorded direct arterial blood pressure recordings,26 as well as defined anesthetic medication protocols and using recently described methods for directly monitoring local indicators of tissue perfusion such as spinal cord blood flow and intraspinal pressure 19, 22, 23, 48. A prospective design in future studies could also utilize recordings of other downstream indicators of tissue perfusion such as plasma l ‐lactate concentration.…”

“…Dogs undergoing longer periods of general anesthesia for more complicated surgical procedures might therefore be subjected to suboptimal spinal cord blood flow, potentially harming SCI recovery. 22,23,48 As a result, a prospective study design utilizing frequent, direct blood pressure recordings including both extremes of fluctuation in a large number of dogs is required to further evaluate the clinical significance of blood pressure in this population of dogs.…”

“…Future studies could therefore better evaluate associations between hemodynamic anesthetic variables and longterm outcome by utilizing more consistent techniques for prospectively monitoring intraoperative systemic perfusion parameters, such as continuously recorded direct arterial blood pressure recordings, 26 as well as defined anesthetic medication protocols and using recently described methods for directly monitoring local indicators of tissue perfusion such as spinal cord blood flow and intraspinal pressure. 19,22,23,48 A prospective design in future studies could also utilize recordings of other downstream indicators of tissue perfusion such as plasma L-lactate concentration. Although the anesthetic drugs used in the current study did not appear to have an association with outcome, there were a limited number of protocols used whereas a prospective study would allow direct evaluation of different treatment groups.…”