Effect of Duration and Onset of Clinical Signs on Short-Term Outcome of Dogs with Hansen Type I Thoracolumbar Intervertebral Disc Extrusion

Abstract

Objective The aim of this study was to determine if either the rate of onset of clinical signs or duration from initial clinical signs to surgical decompression affected the overall quality or duration of recovery in dogs with intervertebral disc extrusion.

Study Design This was a retrospective case series of 131 client owned dogs. Medical records of dogs surgically treated with hemilaminectomy for intervertebral disc extrusion between January 2016 and December 2017 were reviewed for signalment, neurological grade at presentation, rate of onset and duration of clinical signs and surgical variables. These variables were analysed to determine their effect on return of pain sensation, urinary continence and ambulation.

Results Duration of clinical signs prior to surgery and rate of onset of signs did not correlate with return of pain sensation, urinary continence or ambulation. Preoperative neurological grade was the main variable that was found to be associated with outcome.

Conclusions Delay from initial clinical signs of intervertebral disc extrusion to surgery is unlikely to affect the ultimate outcome or the length of time for a dog to regain pain sensation, urinary continence or ambulation. The rate of onset of signs likewise does not influence these outcomes.

Keywords

intervertebral disc extrusion - dog - hemilaminectomy - outcome - surgical timing

Authors' Contributions

David Upchurch contributed to study design, acquisition of data and data analysis and interpretation. Walter Renberg contributed to conception of study and data analysis and interpretation. Hannah Turner contributed to acquisition of data and data analysis and interpretation. Jiena McLellan contributed to study design and data analysis and interpretation. All authors drafted, revised and approved the submitted manuscript.

• References

• 1 Prata RG. Neurosurgical treatment of thoracolumbar disks - The rationale and value of laminectomy with concomitant disk removal. J Am Anim Hosp Assoc 1981; 17 (01) 17-26
• 2 Hansen HJ. A pathologic-anatomical study on disc degeneration in dog, with special reference to the so-called enchondrosis intervertebralis. Acta Orthop Scand Suppl 1952; 11: 1-117
• 3 Davis GJ, Brown DC. Prognostic indicators for time to ambulation after surgical decompression in nonambulatory dogs with acute thoracolumbar disk extrusions: 112 cases. Vet Surg 2002; 31 (06) 513-518
• 4 Macias C, McKee WM, May C, Innes JF. Thoracolumbar disc disease in large dogs: a study of 99 cases. J Small Anim Pract 2002; 43 (10) 439-446
• 5 Ferreira AJ, Correia JH, Jaggy A. Thoracolumbar disc disease in 71 paraplegic dogs: influence of rate of onset and duration of clinical signs on treatment results. J Small Anim Pract 2002; 43 (04) 158-163
• 6 Olby N, Levine J, Harris T, Muñana K, Skeen T, Sharp N. Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001). J Am Vet Med Assoc 2003; 222 (06) 762-769
• 7 Ruddle TL, Allen DA, Schertel ER. , et al. Outcome and prognostic factors in non-ambulatory Hansen type I intervertebral disc extrusions: 308 cases. Vet Comp Orthop Traumatol 2006; 19 (01) 29-34
• 8 Scott HW, McKee WM. Laminectomy for 34 dogs with thoracolumbar intervertebral disc disease and loss of deep pain perception. J Small Anim Pract 1999; 40 (09) 417-422
• 9 Jeffery ND, Levine JM, Olby NJ, Stein VM. Intervertebral disk degeneration in dogs: consequences, diagnosis, treatment, and future directions. J Vet Intern Med 2013; 27 (06) 1318-1333
• 10 Bergman R, Lanz O, Shell L. Acute spinal cord trauma: mechanisms and clinical syndromes. Vet Med 2000; 95 (11) 846-849
• 11 Langerhuus L, Miles J. 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. Vet J 2017; 220: 7-16
• 12 Shaw TA, De Risio L, Laws EJ, Rose JH, Harcourt-Brown TR, Granger N. Prognostic factors associated with recovery of ambulation and urinary continence in dogs with acute lumbosacral spinal cord injury. J Vet Intern Med 2017; 31 (03) 825-831
• 13 Chamisha Y, Aroch I, Kuzi S. , et al. The prognostic value of cerebrospinal fluid characteristics in dogs without deep pain perception due to thoracolumbar disc herniation. Res Vet Sci 2015; 100: 189-196
• 14 Witsberger TH, Levine JM, Fosgate GT. , et al. Associations between cerebrospinal fluid biomarkers and long-term neurologic outcome in dogs with acute intervertebral disk herniation. J Am Vet Med Assoc 2012; 240 (05) 555-562
• 15 Duval J, Dewey C, Roberts R, Aron D. Spinal cord swelling as a myelographic indicator of prognosis: a retrospective study in dogs with intervertebral disc disease and loss of deep pain perception. Vet Surg 1996; 25 (01) 6-12
• 16 Ito D, Matsunaga S, Jeffery ND. , et al. Prognostic value of magnetic resonance imaging in dogs with paraplegia caused by thoracolumbar intervertebral disk extrusion: 77 cases (2000-2003). J Am Vet Med Assoc 2005; 227 (09) 1454-1460
• 17 Henry WB. Dorsal decompressive laminectomy in the treatment of thoracolumbar disc disease. J Am Anim Hosp Assoc 1975; 11: 627-635
• 18 Gambardella PC. Dorsal decompressive laminectomy for treatment of thoracolumbar disk disease in dogs – a retrospective study of 98 cases. Vet Surg 1980; 9 (01) 24-26
• 19 Skytte D, Schmökel H. Relationship of preoperative neurologic score with intervals to regaining micturition and ambulation following surgical treatment of thoracolumbar disk herniation in dogs. J Am Vet Med Assoc 2018; 253 (02) 196-200
• 20 Ingram EA, Kale DC, Balfour RJ. Hemilaminectomy for thoracolumbar Hansen type I intervertebral disk disease in ambulatory dogs with or without neurologic deficits: 39 cases (2008-2010). Vet Surg 2013; 42 (08) 924-931
• 21 Brown NO, Helphrey ML, Prata RG. Thoracolumbar disc disease in the dog: a retrospective analysis of 187 cases. J Am Anim Hosp Assoc 1977; 13: 665-672
• 22 Kazakos G, Polizopoulou ZS, Patsikas MN, Tsimopoulos G, Roubies N, Dessiris A. Duration and severity of clinical signs as prognostic indicators in 30 dogs with thoracolumbar disk disease after surgical decompression. J Vet Med A Physiol Pathol Clin Med 2005; 52 (03) 147-152
• 23 Scott HW. Hemilaminectomy for the treatment of thoracolumbar disc disease in the dog: a follow-up study of 40 cases. J Small Anim Pract 1997; 38 (11) 488-494
• 24 Knecht CD. The effect of delayed hemilaminectomy in the treatment of intervertebral disc protrusion in dogs. J Am Anim Hosp Assoc 1970; 6: 71-77
• 25 Sukhiani HR, Parent JM, Atilola MA, Holmberg DL. Intervertebral disk disease in dogs with signs of back pain alone: 25 cases (1986-1993). J Am Vet Med Assoc 1996; 209 (07) 1275-1279
• 26 Schulman A, Lippincott CL. Dorsolateral hemilaminectomy in the treatment of thoracolumbar intervertebral disk disease in dogs. Compend Contin Educ Pract Vet 1987; 9 (03) 305-310
• 27 Laitinen OM, Puerto DA. Surgical decompression in dogs with thoracolumbar intervertebral disc disease and loss of deep pain perception: A retrospective study of 46 cases. Acta Vet Scand 2005; 46 (1-2): 79-85
• 28 Levine JM, Levine GJ, Kerwin SC, Hettlich BF, Fosgate GT. Association between various physical factors and acute thoracolumbar intervertebral disk extrusion or protrusion in Dachshunds. J Am Vet Med Assoc 2006; 229 (03) 370-375
• 29 Levine JM, Ruaux CG, Bergman RL, Coates JR, Steiner JM, Williams DA. Matrix metalloproteinase-9 activity in the cerebrospinal fluid and serum of dogs with acute spinal cord trauma from intervertebral disk disease. Am J Vet Res 2006; 67 (02) 283-287
• 30 Lim C, Kweon OK, Choi MC, Choi J, Yoon J. Computed tomographic characteristics of acute thoracolumbar intervertebral disc disease in dogs. J Vet Sci 2010; 11 (01) 73-79
• 31 Jeffery ND, Barker AK, Hu HZ. , et al. Factors associated with recovery from paraplegia in dogs with loss of pain perception in the pelvic limbs following intervertebral disk herniation. J Am Vet Med Assoc 2016; 248 (04) 386-394
• 32 Buttin P, Millet M, Cousin S. , et al. Computed tomographic measurements with and without myelography to characterise thoracolumbar extruded disc herniation. J Small Anim Pract 2013; 54 (10) 521-530
• 33 Penning V, Platt SR, Dennis R, Cappello R, Adams V. Association of spinal cord compression seen on magnetic resonance imaging with clinical outcome in 67 dogs with thoracolumbar intervertebral disc extrusion. J Small Anim Pract 2006; 47 (11) 644-650
• 34 Levine JM, Fosgate GT, Chen AV. , et al. Magnetic resonance imaging in dogs with neurologic impairment due to acute thoracic and lumbar intervertebral disk herniation. J Vet Intern Med 2009; 23 (06) 1220-1226