Preliminary evaluation of the effects of photobiomodulation therapy and physical rehabilitation on early postoperative recovery of dogs undergoing hemilaminectomy for treatment of thoracolumbar intervertebral disk disease

Abstract

OBJECTIVE To evaluate the effects of postoperative photobiomodulation therapy and physical rehabilitation on early recovery variables for dogs after hemilaminectomy for treatment of intervertebral disk disease. ANIMALS 32 nonambulatory client-owned dogs. PROCEDURES Dogs received standard postoperative care with photobiomodulation therapy (n = 11), physical rehabilitation with sham photobiomodulation treatment (11), or sham photobiomodulation treatment only (10) after surgery. Neurologic status at admission, diagnostic and surgical variables, duration of postoperative IV analgesic administration, and recovery grades (over 10 days after surgery) were assessed. Time to reach recovery grades B (able to support weight with some help), C (initial limb movements present), and D (ambulatory [≥ 3 steps unassisted]) was compared among groups. Factors associated with ability to ambulate on day 10 or at last follow-up were assessed. RESULTS Time to reach recovery grades B, C, and D and duration of postoperative IV opioid administration did not differ among groups. Neurologic score at admission and surgeon experience were negatively associated with the dogs' ability to ambulate on day 10. The number of disk herniations identified by diagnostic imaging before surgery was negatively associated with ambulatory status at last follow-up. No other significant associations and no adverse treatment-related events were identified. CONCLUSIONS AND CLINICAL RELEVANCE This study found no difference in recovery-related variables among dogs that received photobiomodulation therapy, physical rehabilitation with sham photobiomodulation treatment, or sham photobiomodulation treatment only. Larger studies are needed to better evaluate effects of these postoperative treatments on dogs treated surgically for intervertebral disk disease.

A randomized, blinded, prospective clinical trial of postoperative rehabilitation in dogs after surgical decompression of acute thoracolumbar intervertebral disc herniation

“…The results of our study are in agreement with results from a recent randomized, blinded clinical trial on the efficacy of immediate postoperative laser treatment and rehabilitation in dogs after surgery for TL‐IVDH . This trial included paraplegic, pain perception negative dogs as well as the dogs included in our trial, but like ours, did not find any difference in recovery time and outcome among dogs in the different treatment groups.…”

“…Recommendations on postoperative rehabilitation range from advising against it, to implementing multimodal rehabilitation programs . Objective evidence for the role of rehabilitation in dogs after surgical treatment of TL‐IVDH is sparse, and evidence available is somewhat contradictory with retrospective studies suggesting benefit and a recent, randomized, controlled (RCT) clinical trial failing to demonstrate an effect …”

“…1 Objective evidence for the role of rehabilitation in dogs after surgical treatment of TL-IVDH is sparse, and evidence available is somewhat contradictory with retrospective studies suggesting benefit [10][11][12][13] and a recent, randomized, controlled (RCT) clinical trial failing to demonstrate an effect. 14 Experimental studies in rodents and cats have shown that gait training soon after SCI enhances recovery of locomotion, but have also shown disadvantages such as reduced ability to walk without a treadmill and highlight the importance of task specific training. 15 Numerous RCT in people have concluded that locomotor training in patients with incomplete injuries enhances walking ability with an emphasis on the benefit of duration of training.…”

Perilesional photobiomodulation therapy and physical rehabilitation in post-operative recovery of dogs surgically treated for thoracolumbar disk extrusion

“…Photobiomodulation applied to adult rats that underwent T9 dorsal hemisection resulted in significantly increased axonal number and distance of regrowth [26]. However, recent studies in dogs have published contrasting results on the effects of laser therapy on postoperative IVDH; thus the literature lacks clear evidence-based advantages [27,28].…”

Functional Outcome in Cats with Acute Severe Injuries of the Thoracolumbar Spinal Cord Following Intensive Rehabilitative Physiotherapy

“…The use of physical therapy in veterinary medicine is gradually increasing in the last decade and several studies described its role in the outcome of dogs with thoracolumbar (TL) intervertebral disk herniation (IVDH) [1][2][3][4][5][6]. In cats, many studies were performed under experimental conditions and showed the usefulness of treadmill activity in promoting recovery of motor function in cats after incomplete and complete spinal cord lesions [7][8][9].…”