Will he walk again? Only Dr. Nociception knows!

Thomovsky, Stephanie A.; Chen-Allen, Annie V.

doi:10.1016/j.tvjl.2013.06.023

Cited by 1 publication

(1 citation statement)

References 10 publications

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“…[2][3][4][5]23,42,44,45 Assessment of DPP remains an accepted and commonly applied test for prognosis of recovery in paraplegic dogs with IVDH, 25 although its performance and interpretation have been considered as controversial. 46,47 For long-term functional recovery, presence of DPP in nonambulatory dogs with thoracolumbar IVDH is associated with positive outcomes in nearly 100% of the cases; 2,39,48 however, absence of DPP has been correlated with a recovery rate of approximately 50%. 2,6,25,39 A clear difference is detected in the current study with lower accuracy of DPP to predict early MFR in comparison with formerly reported prediction of long-term MFR.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs with Intervertebral Disk Herniations

Wang‐Leandro

Siedenburg

Hobert

et al. 2017

Veterinary Internal Medicne

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BackgroundPrognostic tools to predict early postoperative motor function recovery (MFR) after thoracolumbar intervertebral disk herniation (IVDH) in paraplegic dogs represent an opportunity to timely implement novel therapies that could shorten recovery times and diminish permanent neurological dysfunctions.HypothesisFractional anisotropy (FA) values obtained using diffusion tensor imaging have a higher prognostic value than a lesion extension ratio in T2‐weighted images (T2W‐LER) and clinical assessment of deep pain perception (DPP) for MFR.AnimalsThirty‐five paraplegic dogs with diagnosis of acute or subacute thoracolumbar IVDH.MethodsProspective, descriptive observational study. At admission, absence or presence of DPP, T2W‐LER, and FA values was evaluated. MFR was assessed within 4 weeks after decompressive surgery. Values of T2W‐LER and FA of dogs with and without MFR were compared using t‐tests. All 3 methods were evaluated for their sensitivity and specificity as a prognostic factor.ResultsNo differences were found between groups regarding T2W‐LER. FA values differed statistically when measured caudally of lesion epicenter being higher in dogs without MFR compared to dogs with MFR (P = .023). Logistic regression analysis revealed significance in FA values measured caudally of the lesion epicenter (P = .033, area under the curve = 0.72). Using a cutoff value of FA = 0.660, the technique had a sensitivity of 80% and a specificity of 55%. Evaluation of DPP had a sensitivity of 73.3% and specificity of 75% (P = .007).Conclusions and Clinical ImportanceEvaluation of DPP showed a similar sensitivity and a better specificity predicting early MFR than quantitative magnetic resonance imaging.

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