Short-term clinical outcomes of 220 dogs with thoraco-lumbar disc disease treated by mini-hemilaminectomy.

Thoraco-lumbar intervertebral disc extrusion is a common condition seen in veterinary practice. Although there are different surgical techniques described for decompression, most of these techniques are based on the surgeon's preference or experience rather than clinical research. Our objective was to determine the clinical outcomes, using return to ambulation and micturition, as well as complication rates, in a large cohort of dogs by using a mini-hemilaminectomy for decompression of the thoraco-lumbar spinal cord with Hansen type I thoraco-lumbar intervertebral disc extrusions (IVDE). A retrospective study was performed on dogs presented for acute thoraco-lumbar IVDE undergoing surgical decompression. In total, 252 spinal decompression surgeries were performed. The recovery rates for patients graded with a modified Frankel score (MFS) of 5 to 0 were 100%, 99%, 100%, 96%, 86% and 64%, respectively. The mean days to micturition across all the MFS 5-0 were 1.5 (standard deviation [SD] ± 0.7), 1.8 (SD ± 1), 4.3 (SD ± 1.7), 6.4 (SD ± 2.2), 9.3 (SD 3) and 11.9 (SD ± 2.2), respectively. The mean days to ambulation across all the groups 5-0 were 2 (SD ± 0.7), 2.6 (SD ± 1), 7.6 (SD ± 4.4), 10.1 (SD ± 2.5), 16.1 (SD ± 2.9) and 19.3 (SD ± 2.6), respectively. Postoperative complications were seen in 32 of the surgeries, with a complication rate of 13%. Minor complications accounted for 38% of all complications, and major complications constituted 62% of all complications. In total, 15 dogs died or were euthanised as a direct result of thoraco-lumbar disc extrusion or the surgical procedure, with a mortality rate of 6% across all groups. A mini-hemilaminectomy provides similar clinical outcomes described in the literature for other methods of spinal cord decompressive surgery, and it also provides patients with similar short-term outcomes to other described decompressive surgical techniques in the dog, which have been described in the literature.

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Estudiamos un niño de tres años de edad con una placa dorsal que había comenzado dos años antes como un nódulo discreto, que se interpretó como un tumor benigno. La lesión aumentó de tamaño en los últimos seis meses y se convirtió en una placa firme, infiltrada, dolorosa a la presión profunda. Se interpretó clínicamente como morfea. La biopsia de piel, de 10 x 4 x 3 mm, mostró esclerosis dérmica e inflamación linfohistiocitaria importante sin granulomas, más notoria en el límite dermohipodérmico, con notorio infiltrado perineural, de difícil diferenciación con lepra indeterminada o dimorfa lepromatosa. Los cortes seriados, la correlación clínico patológica, la ausencia de daño neural notorio en los nervios situados en el centro de la inflamación, la negatividad del Ziehl-Neelsen y la esclerosis dérmica permitieron concluir que el niño tenía morfea. Esta entidad es un diagnóstico diferencial importante clínico de lepra tuberculoide e histológico, de lepra indeterminada. Una biopsia amplia (10 x 5 x 7 mm), con hipodermis, facilita establecer la diferencia por la presencia de esclerosis, propia de la morfea y no de la lepra, por la ausencia de daño intra y perineural en la morfea, en los filetes nerviosos situados dentro del proceso inflamatorio, daño que es muy notorio en la lepra (AU)

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Lumbar cerebrospinal fluid in dogs with type I intervertebral disc herniation.

BACKGROUND: Cerebrospinal fluid (CSF) in dogs with Hansen type I intervertebral disc herniation (IVDH) is classically described as normal or mildly inflammatory with a predominance of large mononuclear cells or neutrophils in severe acute herniations. However, we have observed a moderate to marked pleocytosis with a predominance of lymphocytes in some dogs with IVDH. HYPOTHESIS: Moderate to marked CSF pleocytosis occurs more commonly in dogs with type I IVDH than is reported in the literature. Lymphocytic predominance is more common than nonlymphocytic pleocytosis in dogs with chronic IVDH. ANIMALS: Four hundred twenty-three client-owned dogs with type I IVDH. METHODS: Retrospective study. Lumbar CSF of dogs with surgically confirmed type I IVDH was evaluated cytologically. Information obtained from medical records included signalment, prior clinical history, time from onset of signs to presentation, neurologic status, and intraoperative findings. Dogs with prior history and/or intraoperative evidence consistent with chronic IVDH before an acute herniation were termed acute-on-chronic (AOC). RESULTS: Pleocytosis (> 5 cells/uL) was present in 51% of dogs, including 23% with cervical IVDH and 61% with thoracolumbar IVDH. Moderate or marked inflammation (> or = 20 cells/uL) was identified in the CSF of 51% of dogs with thoracolumbar IVDH and pleocytosis. A predominance of lymphocytes was significantly more common in dogs examined > 7 days from onset of signs (P= .032) and in dogs with AOC IVDH (P= .0013). CONCLUSIONS AND CLINICAL IMPORTANCE: Moderate to marked CSF pleocytosis in dogs with type I IVDH is more common than previously reported. Lymphocytic pleocytosis is most common in dogs with chronic progression or AOC IVDH. Lymphocytic inflammation in the CSF of some dogs might suggest an immune-mediated response to chronically herniated disc material.