Malignant tumor of peripheral nerve sheath in the thoracolumbar region in a cat

Background: In veterinary medicine, peripheral nerve tumors (PNST) are classified from the cellular pattern and as benign and malignant (MPNST). The majorities of cases are benign and usually involve the skin and subcutaneous tissue of the head, neck, and limbs. Animals with MPTNS usually have spinal cord and spinal canal involvement and are also described in the small and large intestine, oral cavity, perirenal region, and urinary bladder. Treatment is performed according to the location of the neoplasm and metastasis is rarely described. The present article aims to report a case of a malignant tumor in the peripheral nerve sheath of a cat. Case: A 8-year-old domestic cat was presented with a history of progressive paresis in the pelvic limbs. On neurological evaluation, proprioceptive ataxia and proprioception deficit in the pelvic limbs were observed, suggestive of thoracolumbar injury. Blood work and serum biochemistry showed results within the reference for the species and the bi-directional immunochromatography test for FIV and FeLV were negative. The radiographs of the thoracolumbar segment did not show significant changes. Myelography with iodinated contrast and collection of cerebrospinal fluid (CSF) were performed. On myelography examination, iodinated contrast loss was found between the 6th and 7th thoracic vertebrae, while the CSF analysis was normal. The patient underwent laminectomy and durotomy for excision of a mass found dorsally to the spinal cord, with intradural location. The tumor was sent for histopathological examination. Microscopic analysis showed neoplastic proliferation of spindle-shaped cells with predominance of the Antoni A pattern. Immunohistochemical analysis demonstrated intense cytoplasmic staining of the neoplastic cells for vimentin and S100 protein. Based on these findings, the diagnosis of malignant peripheral nerve sheath tumor was made. Radiotherapy was suggested as adjuvant treatment after surgical procedure. However, the owner refuse to follow this recommendation due to cost restriction. The patient had a satisfactory clinical recovery, he has no longer presented proprioceptive ataxia or proprioception deficits in three months after the surgical procedure. Discussion: In the case described, the feline patient presented a history, clinical signs, and findings in the myelography exam related to MPNST in the region of the vertebral canal. This neoplasm usually involves the spinal canal or spinal cord, but has been described in other locations, such in the small and large intestine, oral cavity, perirenal region, and urinary bladder. Based on the findings of the physical examination and complementary exams, a surgical procedure was recommended. Then, laminectomy and dutoromy were performed to remove the mass. The treatment described in the literature in cases of MPTNS is surgery, which can be curative, but in some cases, the use of radiotherapy may be necessary. The histological patterns observed in this neoplasm are the Antoni A and B, in the case described the Antoni A pattern was observed. The definitive diagnosis was made by immunohistochemistry with vimentin and S100 protein. MPNST are few described in the thoracolumbar region in cats. The surgical treatment was curative, where improvement of the clinical signs could be observed three months after surgery. In addition, monitoring of patients is recommended to ascertain relapses and metastases.

Analgesia pós-operatória com Fentanil transdérmico ou Metadona intramuscular em cães submetidos à hemilaminectomia toracolombar / Postoperative analgesia with transdermal Fentanyl or intramuscular Methadone in dogs submitted to thoracolumbar hemilaminectomy

Background: Postoperative care after thoracolumbar hemilaminectomy in dogs generally includes rest, physical therapy,and analgesics such as opioids. Currently, there is no established standard for the management of postoperative pain inpatients undergoing hemilaminectomy. Ideally, an analgesic protocol should provide adequate pain relief with limited sedation, low adverse effects, and postoperative patient comfort. Therefore, this study aimed to evaluate postoperative analgesiausing transdermal fentanyl or intramuscular methadone in dogs undergoing thoracolumbar hemilaminectomy associatedwith intervertebral disc fenestration (HT) for the treatment of intervertebral disc extrusion (IVDE).Materials, Methods & Results: Eight dogs from the Department of Neurology and Neurosurgery of a Veterinary TeachingHospital, submitted to HT for the treatment of IVDE, were included. The dogs were randomly distributed into 2 groups ofequal numbers, namely the transdermal fentanyl (FT) group and the intramuscular methadone (IM) group. At the end ofthe surgical procedure, a fentanyl adhesive patch was applied to the animals in the FT group, which remained there for 72h. In the IM group, analgesia was induced by intramuscular administration of methadone at intervals of 6 h until 72 h aftersurgery. The animals were evaluated using the short form of the Glasgow Composite Measure Pains Scale (CMPS-SF).Evaluations of physiological parameters, side effects, and pain were performed by 2 assessors who had experience usingthe pain scale and were blinded to the analgesic protocol. Pain evaluations were performed every 2 h (from T4) until 24h after the surgical procedure. Evaluations were performed every 4 h from 24 h to 48 h after the surgical procedure and...

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion

ABSTRACT: The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.

RESUMO: O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.

Cervical ventral slot in rabbits (Oryctolagus cuniculus). Piezosurgery versus conventional technique

ABSTRACT Purpose To investigate the applicability of piezosurgery for cervical ventral slot (CVS), comparing it with the conventional technique of using high-speed burs for bone wear. Methods Thirty rabbits (Oryctolagus cuniculus) were divided into two treatment groups (T1 and T2) corresponding to CVS between C3-C4. In T1, the surgery was performed with piezoelectric apparatus, and in T2 with high-speed burs. The evaluated parameters were: duration of each stage of surgery, temperature variations during CVS, visibility of the surgical field, intra and postoperative complications, and anesthetic monitoring. At 14, 28, and 56 postoperative days, five animals from each treatment group were submitted for histopathological study of the surgical site. Results Compared with T2, T1 had more precise bone cut, and better visibility of the operative field, although it required longer total surgical time (p = 0.02) and triggered a greater number of intraoperative complications (p < 0.01), microscopic lesions in the spinal cord (p < 0.05), and transient neurological deficits in the postoperatively (p < 0.05). Conclusions It is necessary to perform surgical planning and have several tips of the piezoelectric instrument available for the safe use of the piezoelectric device in neurosurgery.

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion / A necessidade de opioide na analgesia pós-operatória de cães submetidos à hemilaminectomia devido à extrusão do disco intervertebral

The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.(AU)

O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.(AU)

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion / A necessidade de opioide na analgesia pós-operatória de cães submetidos à hemilaminectomia devido à extrusão do disco intervertebral

The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.(AU)

O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.(AU)

Fraturas e luxações vertebrais em cães / Vertebral fractures and luxation in dogs

Background: Vertebral fractures and luxations (VFL) are a major cause of neurologic injury in small animals. They aremost commonly associated with severe external trauma from road traffic accidents, aggression, or falls from heights. Therewere few studies concerning VFL, mainly on results of treatments and sequelae. This retrospective work aimed to studypatients with extrinsic trauma in the spinal cord that were treated at the Neurology and Neurosurgery Service of a HigherEducation Institution in Brazil from 2007 to 2018, describing main etiologies, location of lesion, degree of neurologicaldysfunction, treatment, results and sequelae after surgical or conservative therapy.Materials, Methods & Results: One hundred and nine dogs of various breed and ages were included in this study. Themain etiology of the spinal cord injury in these dogs were fractures and/or dislocations caused by road traffic accidents(66%), followed by interaction with other animals (5.5%). The body region most frequently affected by the lesions were thethoracolumbar segment (T3-L3) of the vertebral spine (52.3%), followed the lumbosacral segment [L4-S3] (38.5%). Thedegrees of the most prevalent neurological dysfunctions for each of the segments were grade V in 73.7% of the dogs withlesions between T3-L3, and grade III in 54.8% of the dogs with lesions in L4-S3. Twenty-one tutors of dogs subjected tosurgery and 20 tutors of dogs that underwent clinical treatment could be contacted by phone. Statistical analysis performedon data from these patients indicated that there was no significant correlation between the motor recovery and the type oftreatment instituted. However, when the degree of motor dysfunction was analyzed in conjunction with recovery, mildergrades were found to be accompanied by the best recovery results.Discussion: Road traffic accidents were the most common cause of damage to the spinal cord, a finding described inother studies on...

Fraturas e luxações vertebrais em cães / Vertebral fractures and luxation in dogs

Background: Vertebral fractures and luxations (VFL) are a major cause of neurologic injury in small animals. They aremost commonly associated with severe external trauma from road traffic accidents, aggression, or falls from heights. Therewere few studies concerning VFL, mainly on results of treatments and sequelae. This retrospective work aimed to studypatients with extrinsic trauma in the spinal cord that were treated at the Neurology and Neurosurgery Service of a HigherEducation Institution in Brazil from 2007 to 2018, describing main etiologies, location of lesion, degree of neurologicaldysfunction, treatment, results and sequelae after surgical or conservative therapy.Materials, Methods & Results: One hundred and nine dogs of various breed and ages were included in this study. Themain etiology of the spinal cord injury in these dogs were fractures and/or dislocations caused by road traffic accidents(66%), followed by interaction with other animals (5.5%). The body region most frequently affected by the lesions were thethoracolumbar segment (T3-L3) of the vertebral spine (52.3%), followed the lumbosacral segment [L4-S3] (38.5%). Thedegrees of the most prevalent neurological dysfunctions for each of the segments were grade V in 73.7% of the dogs withlesions between T3-L3, and grade III in 54.8% of the dogs with lesions in L4-S3. Twenty-one tutors of dogs subjected tosurgery and 20 tutors of dogs that underwent clinical treatment could be contacted by phone. Statistical analysis performedon data from these patients indicated that there was no significant correlation between the motor recovery and the type oftreatment instituted. However, when the degree of motor dysfunction was analyzed in conjunction with recovery, mildergrades were found to be accompanied by the best recovery results.Discussion: Road traffic accidents were the most common cause of damage to the spinal cord, a finding described inother studies on...(AU)

Corpectomia lateral parcial para o tratamento de compressão ventral extradural crônica entre T9-T10 em um cão / Partial lateral corpectomy for treatment of chronic ventral extradural compression between T9-T10 in a dog

Objetivou-se relatar um caso de protrusão do disco intervertebral com localização atípica e descrever a técnica cirúrgica de corpectomia lateral parcial no tratamento da afecção em um cão. Um cão de sete anos de idade, macho, raça Pug, foi atendido com ataxia proprioceptiva dos membros pélvicos havia três meses, associada à doença do disco intervertebral entre a nona e 10ª vértebras torácicas. Após um mês de tratamento conservativo sem melhora, o paciente foi encaminhado para o tratamento cirúrgico, quando foi realizada corpectomia lateral parcial esquerda para descompressão da medula espinhal. Após a cirurgia, o paciente apresentou melhora considerável do quadro, sendo a técnica eficaz na remoção da compressão extradural, sem manipulação da medula espinhal ou outras complicações.(AU)

The aim of this study is to report a case of intervertebral disc protrusion with atypical location and describe the surgical technique of partial lateral corpectomy in the treatment of this disease in a dog. A dog, seven -years-old, male, Pug breed was attended with proprioceptive ataxia of the hind limbs for three months correlated with intervertebral disc disease between the 9th and 10th thoracic vertebrae. After a month of conservative treatment without improvements, the patient was referred for surgical treatment, which was performed as a partial left lateral corpectomy for decompression of the spinal cord. After surgery, the patient showed considerable improvement, this technique being shown to be effective in the removal of extradural compression, without manipulation of the spinal cord or other complications.(AU)

Corpectomia lateral parcial para o tratamento de compressão ventral extradural crônica entre T9-T10 em um cão / Partial lateral corpectomy for treatment of chronic ventral extradural compression between T9-T10 in a dog

Objetivou-se relatar um caso de protrusão do disco intervertebral com localização atípica e descrever a técnica cirúrgica de corpectomia lateral parcial no tratamento da afecção em um cão. Um cão de sete anos de idade, macho, raça Pug, foi atendido com ataxia proprioceptiva dos membros pélvicos havia três meses, associada à doença do disco intervertebral entre a nona e 10ª vértebras torácicas. Após um mês de tratamento conservativo sem melhora, o paciente foi encaminhado para o tratamento cirúrgico, quando foi realizada corpectomia lateral parcial esquerda para descompressão da medula espinhal. Após a cirurgia, o paciente apresentou melhora considerável do quadro, sendo a técnica eficaz na remoção da compressão extradural, sem manipulação da medula espinhal ou outras complicações.(AU)

The aim of this study is to report a case of intervertebral disc protrusion with atypical location and describe the surgical technique of partial lateral corpectomy in the treatment of this disease in a dog. A dog, seven -years-old, male, Pug breed was attended with proprioceptive ataxia of the hind limbs for three months correlated with intervertebral disc disease between the 9th and 10th thoracic vertebrae. After a month of conservative treatment without improvements, the patient was referred for surgical treatment, which was performed as a partial left lateral corpectomy for decompression of the spinal cord. After surgery, the patient showed considerable improvement, this technique being shown to be effective in the removal of extradural compression, without manipulation of the spinal cord or other complications.(AU)

Contribuições ao estudo da doença do disco intervertebral em cães

A doença do disco intervertebral (DDIV) toracolombar (TL) é uma causa comum de disfunção neurológica em cães. DDIV é um termo amplo utilizado para se referir a uma série de alterações que afetam o disco intervertebral de cães e que podem envolver ou não a sua degeneração. A extrusão de disco intervertebral intradural (EDIVI) é um dos tipos raros de DDIV, que pode afetar a região da medula espinhal TL de cães. A EDIVI é de difícil diagnóstico e ainda existem dúvidas quanto ao seu tratamento. O artigo 1 da presente tese apresenta um relato de caso de EDIVI, em que o diagnóstico foi realizado no período transoperatório. As alterações de mielografia foram inconclusivas e a decisão cirúrgica foi tomada com base no histórico, achados clínicos e no exame radiografico simples. O procedimento cirúrgico permitiu a adequada recuperação do paciente e a colheita e análise do material removido, durante a cirurgia, permitiu o diagnóstico definitivo de EDIVI. Já a extrusão de disco intervertebral (EDIV) extradural TL é a apresentação mais comum da DDIV em cães. Cães que apresentam paraplegia sem percepção à dor profunda, secundária à EDIV, possuem prognóstico desfavorável quando permanecem muito tempo sem tratamento cirúrgico. O artigo 2 relata os resultados de retorno à deambulação de cães, submetidos à cirurgia para tratamento de EDIV TL, a partir de 96 horas (quatro dias) ou mais de paraplegia sem percepção à dor profunda. Os resultados permitiram afirmar que existe possibilidade acima de 45% de retorno à deambulação para esses cães quando instituído o tratamento cirúrgico. Por fim, podemos acrescentar que a DDIV ainda apresenta um vasto campo de estudos clínicos para melhor compreensão dos processos nela envolvidos e na abordagem ao paciente acometido.

Thoracolumbar (TL) intervertebral disc disease (IVDD) is a common cause of neurological dysfunction in dogs. IVDD is a broad term used to refer to a series of diseases that affect the intervertebral disc of dogs, and that may or may not involve degeneration of the disc. Intradural intervertebral disc extrusion (IIVDE) is one of the rare types of IVDD, that can affect the TL spinal cord region of dogs. IIVDE is difficult to diagnose and there are still doubts about treatment. Article 1 of the present thesis presents a case report of IIVDE, whose diagnosis was made during the transoperative period. The changes in myelography were inconclusive and the surgical decision was made based on history, clinical findings and simple radiography. The surgery allowed adequate recovery of the patient and the collection and analysis of the material removed during the surgery allowed the definitive diagnosis of IIVDE. Toracolumbar intervertebral disc extrusion (IVDE) (extradural) is the most common presentation of IVDD in dogs. Dogs with paraplegia without deep pain perception, secondary to IVDE, have questionable prognosis, when they remain without surgical treatment for a long time. The article 2 shows results of the return to ambulation of dogs submitted to surgery to treat TL IVDE, with 96 hours (four days) or more of paraplegia without deep pain perception. The results allow us to affirm that there is a possibility above 45% of return to walking for these dogs when treated surgically. Finally, we can add that IVDD still presents a vast field of clinical studies to better understand the processes involved and to better approach the patient affected by it.

Mesenchymal stem cells promote augmented response of endogenous neural stem cells in spinal cord injury of rats / Células-tronco mesenquimais ampliam a resposta de células-tronco neurais endógenas no trauma da medula espinhal em ratos

Traumatic spinal cord injury results in severe neurological deficits, mostly irreversible. The cell therapy represents a strategy for treatment particularly with the use of stem cells with satisfactory results in several experimental models. The aim of the study was to compare the treatment of spinal cord injury (SCI) with and without mesenchymal stem cells (MSC), to investigate whether MSCs migrate and/or remain at the site of injury, and to analyze the effects of MSCs on inflammation, astrocytic reactivity and activation of endogenous stem cells. Three hours after SCI, animals received bone marrow-derived MSCs (1×107 in 1mL PBS, IV). Animals were euthanized 24 hours, 7 and 21 days post-injury. The MSC were not present in the site of the lesion and the immunofluorescent evaluation showed significant attenuation of inflammatory response with reduction in macrophages labeled with anti-CD68 antibody (ED1), decreased immunoreactivity of astrocytes (GFAP+) and greater activation of endogenous stem cells (nestin+) in the treated groups. Therefore, cell transplantation have a positive effect on recovery from traumatic spinal cord injury possibly due to the potential of MSCs to attenuate the immune response.(AU)

A lesão medular resulta em déficits neurológicos graves, a maioria irreversíveis. A terapia celular representa uma estratégia para o tratamento, especialmente com a utilização de células-tronco, com resultados satisfatórios em vários modelos experimentais. O objetivo do estudo foi comparar o tratamento de lesões da medula espinal (SCI), com e sem o uso de células-tronco mesenquimais (MSC), para investigar se as MSCs migram e/ou permanecem no local de lesão, e para analisar os efeitos de MSCs sobre a inflamação, reatividade astrocitária e ativação das células-tronco endógenas. Três horas depois da SCI, os animais receberam as MSC derivadas da medula óssea (1 × 107 em 1 mL de PBS, IV). Os animais foram sacrificados 24 horas, 7 e 21 dias pós-lesão. As MSC não estavam presentes no local da lesão e a avaliação por imunofluorescência demonstrou atenuação significativa da resposta inflamatória com redução em macrófagos marcados com anticorpo anti CD68 (ED1), diminuição da imunorreatividade de astrócitos (GFAP +) e maior ativação das células-tronco endógenas (nestin+) nos grupos tratados. Assim, o transplante de células teve efeito positivo sobre a recuperação de lesão traumática da medula espinal, possivelmente devido ao potencial das MSCs para atenuar a resposta imunológica.(AU)

Mesenchymal stem cells promote augmented response of endogenous neural stem cells in spinal cord injury of rats / Células-tronco mesenquimais ampliam a resposta de células-tronco neurais endógenas no trauma da medula espinhal em ratos

Traumatic spinal cord injury results in severe neurological deficits, mostly irreversible. The cell therapy represents a strategy for treatment particularly with the use of stem cells with satisfactory results in several experimental models. The aim of the study was to compare the treatment of spinal cord injury (SCI) with and without mesenchymal stem cells (MSC), to investigate whether MSCs migrate and/or remain at the site of injury, and to analyze the effects of MSCs on inflammation, astrocytic reactivity and activation of endogenous stem cells. Three hours after SCI, animals received bone marrow-derived MSCs (1×107 in 1mL PBS, IV). Animals were euthanized 24 hours, 7 and 21 days post-injury. The MSC were not present in the site of the lesion and the immunofluorescent evaluation showed significant attenuation of inflammatory response with reduction in macrophages labeled with anti-CD68 antibody (ED1), decreased immunoreactivity of astrocytes (GFAP+) and greater activation of endogenous stem cells (nestin+) in the treated groups. Therefore, cell transplantation have a positive effect on recovery from traumatic spinal cord injury possibly due to the potential of MSCs to attenuate the immune response.

A lesão medular resulta em déficits neurológicos graves, a maioria irreversíveis. A terapia celular representa uma estratégia para o tratamento, especialmente com a utilização de células-tronco, com resultados satisfatórios em vários modelos experimentais. O objetivo do estudo foi comparar o tratamento de lesões da medula espinal (SCI), com e sem o uso de células-tronco mesenquimais (MSC), para investigar se as MSCs migram e/ou permanecem no local de lesão, e para analisar os efeitos de MSCs sobre a inflamação, reatividade astrocitária e ativação das células-tronco endógenas. Três horas depois da SCI, os animais receberam as MSC derivadas da medula óssea (1 × 107 em 1 mL de PBS, IV). Os animais foram sacrificados 24 horas, 7 e 21 dias pós-lesão. As MSC não estavam presentes no local da lesão e a avaliação por imunofluorescência demonstrou atenuação significativa da resposta inflamatória com redução em macrófagos marcados com anticorpo anti CD68 (ED1), diminuição da imunorreatividade de astrócitos (GFAP +) e maior ativação das células-tronco endógenas (nestin+) nos grupos tratados. Assim, o transplante de células teve efeito positivo sobre a recuperação de lesão traumática da medula espinal, possivelmente devido ao potencial das MSCs para atenuar a resposta imunológica.

Uso do Clamp and Rod Internal Fixation pedicular na estabilização da coluna lombossacra em felino: relato de caso / The Clamp and Rod Internal Fixation pedicular stabilization of the lumbosacral spine in feline: case report

Objetivou-se reportar, pela primeira vez descrita até então, a fixação de uma fratura de sétima vértebra lombar (L7) com luxação de L7-S1, por meio de fixação pedicular, utilizando-se Clamp and Rod Internal Fixation (CRIF) em um gato. Um felino de um ano de idade, macho, SRD, foi atendido com histórico de atropelamento havia sete dias, apresentando paraparesia não ambulatória secundária à fratura da sétima vértebra lombar e compressão da cauda equina. Após avaliação geral do paciente, no dia seguinte, ele foi submetido à cirurgia descompressiva por meio de laminectomia dorsal e posterior estabilização pedicular entre L7 e S1, utilizando-se CRIF bilateralmente. O paciente apresentou evolução favorável com deambulação normal após 15 dias do procedimento cirúrgico.(AU)

The aim was to report the establishment of a seventh lumbar vertebra fracture (L7), the first described so far, with L7 -S1 luxation through pedicle fixation using Clamp and Rod Internal Fixation (CRIF) on a cat. A 1 year old male mongrel feline was attended with a history of being hit by car seven days prior, with no ambulatory paraparesis secondary to fracture of the seventh lumbar vertebrae and compression of the cauda equina. After general evaluation of the patient, the next day, the patient was submitted to decompressive surgery through dorsal laminectomy and posterior pedicle stabilization between L7 and S1 using CRIF bilaterally. The patient presented a favorable outcome with normal ambulation after 15 days of surgery.(AU)

Uso do Clamp and Rod Internal Fixation pedicular na estabilização da coluna lombossacra em felino: relato de caso / The Clamp and Rod Internal Fixation pedicular stabilization of the lumbosacral spine in feline: case report

Objetivou-se reportar, pela primeira vez descrita até então, a fixação de uma fratura de sétima vértebra lombar (L7) com luxação de L7-S1, por meio de fixação pedicular, utilizando-se Clamp and Rod Internal Fixation (CRIF) em um gato. Um felino de um ano de idade, macho, SRD, foi atendido com histórico de atropelamento havia sete dias, apresentando paraparesia não ambulatória secundária à fratura da sétima vértebra lombar e compressão da cauda equina. Após avaliação geral do paciente, no dia seguinte, ele foi submetido à cirurgia descompressiva por meio de laminectomia dorsal e posterior estabilização pedicular entre L7 e S1, utilizando-se CRIF bilateralmente. O paciente apresentou evolução favorável com deambulação normal após 15 dias do procedimento cirúrgico.(AU)

The aim was to report the establishment of a seventh lumbar vertebra fracture (L7), the first described so far, with L7 -S1 luxation through pedicle fixation using Clamp and Rod Internal Fixation (CRIF) on a cat. A 1 year old male mongrel feline was attended with a history of being hit by car seven days prior, with no ambulatory paraparesis secondary to fracture of the seventh lumbar vertebrae and compression of the cauda equina. After general evaluation of the patient, the next day, the patient was submitted to decompressive surgery through dorsal laminectomy and posterior pedicle stabilization between L7 and S1 using CRIF bilaterally. The patient presented a favorable outcome with normal ambulation after 15 days of surgery.(AU)

Retrospective study of anesthesias in dogs and cats underwent to neurosurgery / Estudo retrospectivo das anestesias realizadas em cães e gatos submetidos à neurocirurgia

Background: The goal of anesthesia in patients with neurological diseases is to maintain the homeostasis of the central nervous system, focusing on intracranial pressure and pain during the intraoperative period. The purpose of this study was to evaluate the anesthesia performed between January 2010 and January 2016 at the Veterinary Clinical Hospital at the Federal University of Rio Grande do Sul and correlate the types of surgeries, drugs used in the pre-anesthetic medication, induction, pain control, and the development of complications during the procedure. Materials, Methods & Results: The medical records of 242 patients, who presented with neurological signs of spinal cord compression or traumatic brain injury, were assessed. Only 70 patients who underwent surgery had properly documented and detailed anesthesia records. Of these 70, there were 32 male and 38 female animals, with one feline and 69 canines. Their weights on the day of surgery ranged between 1.5 kg and 38 kg and their ages ranged from six months up to 13 years. We evaluated 74 surgeries because four patients underwent two separate surgeries. There were 38 hemilaminectomies, 14 ventral slots, seven vertebral stabilizations (one atlantoaxial instability and six vertebral fractures), six dorsal laminectomies, four pediculectomies, two fenestrations with hemilaminectomy, one durotomy with hemilaminectomy, on [...](AU)

Retrospective study of anesthesias in dogs and cats underwent to neurosurgery / Estudo retrospectivo das anestesias realizadas em cães e gatos submetidos à neurocirurgia

Background: The goal of anesthesia in patients with neurological diseases is to maintain the homeostasis of the central nervous system, focusing on intracranial pressure and pain during the intraoperative period. The purpose of this study was to evaluate the anesthesia performed between January 2010 and January 2016 at the Veterinary Clinical Hospital at the Federal University of Rio Grande do Sul and correlate the types of surgeries, drugs used in the pre-anesthetic medication, induction, pain control, and the development of complications during the procedure. Materials, Methods & Results: The medical records of 242 patients, who presented with neurological signs of spinal cord compression or traumatic brain injury, were assessed. Only 70 patients who underwent surgery had properly documented and detailed anesthesia records. Of these 70, there were 32 male and 38 female animals, with one feline and 69 canines. Their weights on the day of surgery ranged between 1.5 kg and 38 kg and their ages ranged from six months up to 13 years. We evaluated 74 surgeries because four patients underwent two separate surgeries. There were 38 hemilaminectomies, 14 ventral slots, seven vertebral stabilizations (one atlantoaxial instability and six vertebral fractures), six dorsal laminectomies, four pediculectomies, two fenestrations with hemilaminectomy, one durotomy with hemilaminectomy, on [...]

Prednisona e meloxicam no tratamento de ratos submetidos ao trauma agudo da medula espinhal / Prednisone and meloxicam in the treatment of rats underwent to acute spinal cord injury

O objetivo deste estudo foi investigar o efeito da prednisona e do meloxicam na terapia de ratos submetidos ao modelo experimental de trauma agudo da medula espinhal, induzida pelo cateter de Fogarty 2Fr, mediante a avaliação dos parâmetros de estresse oxidativo, dos testes neurológicos e do exame histopatológico da medula espinhal. Foram utilizados 90 ratos Wistar, distribuídos em seis grupos, denominados controle salina ou GCS (n=15), controle prednisona ou GCP (n=15), controle meloxicam ou GCM (n=15), trauma mais salina ou GTS (n=15), trauma mais prednisona ou GTP (n=15) e trauma mais meloxicam GTM (n=15). Cada grupo foi redistribuído em três subgrupos de igual número, de acordo com o tempo de tratamento no pós-operatório de 24h, 72h e sete dias. Todos os grupos foram submetidos à laminectomia e, nos grupos GTS, GTM e GTP, após a exposição da medula espinhal, foi realizado o trauma medular compressivo, utilizando o cateter de Fogarty 2Fr. Os grupos GCS e GTS foram tratados com solução salina, os GSM e GTM receberam meloxicam e os GSP e GTP prednisona, sendo administrados pela via intraperitoneal. Em todos os ratos, foram avaliados os parâmetros de estresse oxidativo, testes neurológicos e exame histopatológico da medula espinhal. Os animais dos grupos GTS, GTM e GTP, nos diferentes tempos (24h, 72h e sete dias), tiveram pontuação zero na escala de Basso, Beattie e Bresnahan (BBB); no plano inclinado, permaneceram com pontuação três e perderam a percepção da dor profunda. Os grupos GTM e GTP apresentaram menor atividade da catalase e de níveis de TBARS, quando comparado ao grupo GTS. Foi constatada degeneração Walleriana e necrose da substância cinzenta de intensidades variáveis, não apresentando diferença entre os grupos submetidos ao trauma. O meloxicam e a prednisona apresentam possível efeito antioxidante, mas não impedem a necrose e a degeneração Walleriana da medula espinhal de ratos.(AU)

The aim of the study was investigate the use of the prednisone and meloxicam in treatment of rats underwent to the experimental model of acute spinal cord injury with 2Fr Fogarty catheter, with evaluation of the oxidative stress, neurological test and histopathological analysis of the spinal cord. Ninety rats were separated into six equal groups denominated saline control or SCG, prednisone control or PCG, meloxicam control or MCG, saline and injury or STG, prednisone and injury PTG and meloxicam and injury MTG. Each group was divide into three subgroups according to treatment time in the postoperative period of 24h, 72h and seven days. All the rats underwent laminectomy and in the groups STG, MTG and PTG, after exposure of the spinal cord it was performed a compressive spinal cord injury with a 2Fr Fogarty catheter. The SCG and STG were treated with saline, MSG and MTG, with meloxicam and PSG and PTG with prednisone. All rats were evaluated for oxidative stress, neurological tests and histopathology of the spinal cord. Neurological tests were performed with Basso, Beattie e Bresnahan score (BBB), inclined plane and deep pain 24 hours before and after surgery and repeated every 48 hours until the day of euthanasia. The groups STG, MTG and PTG in the different times were zero point in the BBB scale and three points in the inclined plane and absence of deep pain. MTG and PTG had lower catalase activity and TBARS levels when compared to the STG. In the histopathological analysis it was found Wallerian degeneration and necrosis of gray matter of intensity variation. Meloxicam and prednisone can exhibit antioxidant effect, but the necrosis and Wallerian degeneration were not stop in rats underwent to acute spinal cord injury.(AU)

Microsurgical training model with nonliving swine head. Alternative for neurosurgical education

This paper proposes a practical model of microneurosurgical training using a nonliving swine head. Fresh porcine heads were obtained from butchery and dissected at our Laboratory of Microsurgery. Brain and skull base surgery were trained under microscopic magnification. RESULTS: Several neurosurgical procedures could be simulated in the nonliving pig model, including transcallosal approach to the lateral ventricle, lateral sulcus and middle fossa dissection, and posterior fossa surgery. The swine model perfectly simulates standard microneurosurgical procedures, and is a useful tool for developing and refining surgical skills.(AU)

Partial lateral corpectomy associated with pediculectomy to treat extradural chondroma in a dog: technique description / Corpectomia lateral parcial associada à pediculectomia no tratamento de condroma extradural em um cão: descrição da técnica

This study aimed to describe in detail the surgical technique of partial lateral corpectomy (PLC) associated with pediculectomy to treat an in vitro extradural chondroma. A 12-year old female Cocker Spaniel was seen in the hospital with proprioceptive ataxia of hind limbs associated with extradural compression between the 1st and 2nd lumbar vertebrae. The owner opted for euthanasia since the patient's condition changed due to simultaneous illnesses that culminated in a poor prognosis. The patient's body was formally ceded to perform experimental spinal decompression. The technique was effective to completely remove the epidural mass with minimal manipulation of the spinal cord.(AU)

Objetivou-se descrever detalhadamente a técnica cirúrgica de corpectomia lateral parcial associada à pediculectomia no tratamento de um condroma extradural in vitro. Uma cadela de 12 anos de idade, raça Cocker Spaniel, foi atendida com ataxia proprioceptiva dos membros pélvicos associada à compressão extradural entre a primeira e a segunda vértebras lombares. Devido a alterações secundárias decorrentes de afecções concomitantes que culminavam em um prognóstico desfavorável, o proprietário optou pela eutanásia do paciente, e o cadáver foi formalmente cedido para realização de descompressão medular experimental. A técnica utilizada foi eficaz na remoção completa da massa extradural, com mínima manipulação da medula espinhal.(AU)