Proportion recovery and times to ambulation for non-ambulatory dogs with thoracolumbar disc extrusions treated with hemilaminectomy or conservative treatment: A systematic review and meta-analysis of case-series studies

Langerhuus, L.; Miles, James Edward

doi:10.1016/j.tvjl.2016.12.008

Cited by 58 publications

(92 citation statements)

References 42 publications

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“…Our results go a step further, providing evidence that the level of disability prior to loss of pain sensation influences the speed of recovery. This finding is in line with a recent systematic review in which the authors found that combined data from 4 retrospective studies supported the association between increased disability and prolonged recovery …”

Section: Discussionsupporting

confidence: 91%

The effect of body condition on postoperative recovery of dachshunds with intervertebral disc disease treated with postoperative physical rehabilitation

et al. 2018

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Objective: To determine the impact of obesity on postoperative recovery from thoracolumbar hemilaminectomy in dachshunds treated with rehabilitation. Study design: Prospective observational trial. Animals: Thirty-two dachshunds with thoracolumbar intervertebral disk disease and pain perception. Methods: Dachshunds were entered into the study after unilateral thoracolumbar hemilaminectomy. Lean muscle and fat contents were measured with dual-energy x-ray absorptiometry (DEXA) at the beginning and at week 12 of the study. Aggressive rehabilitation was performed 1, 2, 4, and 6 weeks after surgery. Logistic regressions were used to determine the odds ratios between potential risk factors (age, duration of clinical signs, weight, body condition score, percentage body fat, percentage lean muscle mass, and disability index [DI] score at presentation) and return benchmarks of recovery. Results: Body condition score, percentage body fat, percentage lean muscle mass, weight, and age did not influence the odds ratio for recovery. An increase in preoperative DI score was associated with increased risk of a slow postoperative recovery (P < .05). The odds ratios were 2.5, 4.8, and 1.8 for >7 days until standing, > 30 days until strong ambulation, and failure to return to normal within the study period, respectively. On average, dogs lost weight (2.2 kg) and body fat (2.4%) but gained muscle mass (3.0%) over the study period (P < .05). Conclusion: Preoperative disability but not body condition was a risk factor for a slow recovery after thoracolumbar hemilaminectomy in dachshunds with rehabilitation. Clinical significance: A slower recovery is likely with increased preoperative disability, but body condition does not seem to affect the postoperative prognosis of dachshunds treated with rehabilitation.

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Section: Discussionsupporting

confidence: 91%

The effect of body condition on postoperative recovery of dachshunds with intervertebral disc disease treated with postoperative physical rehabilitation

et al. 2018

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“…Former recommendations for decompressive surgery for HNPE generally were based on data evaluated for treatment of cervical IVDH Hansen type I . In the latter, decompressive surgery is recommended if moderate to marked neurological deficits are present .…”

Section: Discussionmentioning

confidence: 99%

Comparison of surgical and conservative treatment of hydrated nucleus pulposus extrusion in dogs

Neßler

Flieshardt²,

Tünsmeyer

et al. 2018

Veterinary Internal Medicne

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BackgroundWhether compressive cervical myelopathy caused by hydrated nucleus pulposus extrusion (HNPE) in dogs should be treated surgically or conservatively has been debated. Only 1 recent study has contradicted the former predominant reports of surgical treatment for HNPE.Hypothesis and methodSingle center retrospective study to compare the outcome of client‐owned dogs with HNPE after decompressive surgery or conservative treatment.AnimalsThirty‐six dogs diagnosed with HNPE confirmed by magnetic resonance imaging (MRI).ResultsEighteen of 36 dogs underwent surgery whereas 18 dogs were managed conservatively including cage rest and physiotherapy. The most common affected intervertebral disc space was C4‐5. In 3 dogs, HNPE was diagnosed at the level of T13‐L1. Median time to regain ambulation was 6.6 days (range, 0‐28 days) after surgery and 5.9 days (range, 0‐15 days) with conservative management (P = .37).Only the length of a potential intramedullary lesion in cervical HNPE detected by MRI had an influence on the prognosis to gain ambulatory status in a time period of ≤9 days (P = .0035) and on short‐term survival (P = .0011).Conclusions and clinical importanceConservative management of HNPE in the cervical as well as in the thoracolumbar region represents a reasonable alternative to surgery, showing similar favorable outcome.

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“…Regarding dogs with an OFS of 1, reported success rates after surgical approach can range from 85-98% (Olby et al, 2003(Olby et al, , 2004Loughin et al, 2005;Ruddle et al, 2006;Aikawa et al, 2012;Draper et al, 2012;Ingram et al, 2013;Langerhuus & Miles, 2017). However, comparison between studies can be di cult…”

Section: Discussionmentioning

confidence: 99%

Intensive Functional Neurorehabilitation and Follow-up of 84 Paraplegic Dogs Affected by Intervertebral Disc Disease

Martins¹,

Gouveia²,

Cardoso³

et al. 2020

Preprint

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BackgroundThe objectives of this study were to verify whether the functionality obtained with functional neurorehabilitation intensive protocols (FNRIP) improve ambulation, promoting a new therapeutic approach, and understand the expected time for functional recovery. Furthermore, to know whether “spinal reflex” locomotion could be a functional locomotory pattern, which may improve the quality of life.A controlled prospective clinical study using a large cohort of 84 dogs comprising mostly chondrodystrophic-breeds. The dogs were diagnosed with T10-L3 Hansen Type I, using computed tomography or magnetic resonance imaging, and treated with hemilaminectomy. All had postsurgical neurological stage 0 or 1, according to the Open Field Score (OFS), and showed either an absent or decreased flexor peripheral reflex. All patients were subjected to FNRIP within a maximum of 3 months, data were recorded on days 1,3,7,15,30,45,60,75, 90 and patients were followed-up after 8-10 days, at 1 and 6 months, and in some cases, after 1 and 2 years. ResultsFifty-one dogs were admitted with an OFS of 1 and were discharged with an OFS of 13 (100% functionality). Of the 29 dogs that were admitted with an OFS 0, 16 were discharged (55%) in an ambulatory state, of which six dogs recovered deep pain perception (DPP) after 4 weeks, and 10 showed functional “spinal reflex” locomotion. 79.3% of these dogs achieved autonomous miction. The results were time-limited, as they were recorded within 2 to 3 months, with follow-up until 6 months. A pattern of sustained functional “spinal reflex” locomotion was observed in 30% of the dogs observed over 2 years.ConclusionsThe FNRIP are viable to regain independence and quality of life in paraplegic dogs with/without DPP, secondary to acute Intervertebral disc disease (IVDD).

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Proportion recovery and times to ambulation for non-ambulatory dogs with thoracolumbar disc extrusions treated with hemilaminectomy or conservative treatment: A systematic review and meta-analysis of case-series studies

Cited by 58 publications

References 42 publications

The effect of body condition on postoperative recovery of dachshunds with intervertebral disc disease treated with postoperative physical rehabilitation

The effect of body condition on postoperative recovery of dachshunds with intervertebral disc disease treated with postoperative physical rehabilitation

Comparison of surgical and conservative treatment of hydrated nucleus pulposus extrusion in dogs

Intensive Functional Neurorehabilitation and Follow-up of 84 Paraplegic Dogs Affected by Intervertebral Disc Disease

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