Langzeitevaluation postoperativer Schmerzen nach thorakolumbaler Hemilaminektomie

2020 ◽  
Vol 48 (05) ◽  
pp. 377-377
Keyword(s):  
Postoperative Pain ◽  
Intervertebral Disc ◽  
Disc Herniation ◽  
Neuropathischer Schmerz ◽  
Intervertebral Disc Herniation ◽  
Pain Evaluation ◽  
Ca 50

Zidan N, Medland J, Olby NJ. Long-term postoperative pain evaluation in dogs with thoracolumbar intervertebral disc herniation after hemilaminectomy. J Vet Intern Med 2020. doi: 10.1111/jvim.15800. Beim Menschen ist chronischer neuropathischer Schmerz eine häufige Komplikation nach Rückenmarksinsulten, ca. 50–80 % der Patienten entwickeln eine derartige Dolenz. Für den Hund liegen diesbezüglich keine Studiendaten vor, vor allem aufgrund der herausfordernden Evaluierung insbesondere von neuropathischen Schmerzzuständen. Diese Studie prüfte die Verlässlichkeit einer Messung von spinalen mechanisch ausgelösten sensorischen Schwellenwerten (mechanical sensory threshholds, MSTs) und verglich die MSTs gesunder Hunde mit denen von Hunden nach operativer Hemilaminektomie aufgrund einer thorakolumbaren intervertebralen Diskherniation (IVDH).

scholarly journals Outcomes after incidental durotomy during first-time lumbar discectomy

2011 ◽  
Vol 14 (5) ◽  
pp. 647-653 ◽  
Author(s):  
Atman Desai ◽  
Perry A. Ball ◽  
Kimon Bekelis ◽  
Jon D. Lurie ◽  
Sohail K. Mirza ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Disc Herniation ◽  
Lumbar Discectomy ◽  
Intervertebral Disc Herniation ◽  
Long Term Outcome ◽  
Nerve Root Injury ◽  
Incidental Durotomy ◽  
First Time

Object Incidental durotomy is an infrequent but well-recognized complication during lumbar disc surgery. The effect of a durotomy on long-term outcomes is, however, controversial. The authors sought to examine whether the occurrence of durotomy during surgery impacts long-term clinical outcome. Methods Spine Patient Outcomes Research Trial (SPORT) participants who had a confirmed diagnosis of intervertebral disc herniation and were undergoing standard first-time open discectomy were followed up at 6 weeks and at 3, 6, and 12 months after surgery and annually thereafter at 13 spine clinics in 11 US states. Patient data from this prospectively gathered database were reviewed. As of May 2009, the mean (± SD) duration of follow-up among all of the intervertebral disc herniation patients whose data were analyzed was 41.5 ± 14.5 months (41.4 months in those with no durotomy vs 40.2 months in those with durotomy, p < 0.68). The median duration of follow-up among all of these patients was 47 months (range 1–95 months). Results A total of 799 patients underwent first-time lumbar discectomy. There was an incidental durotomy in 25 (3.1%) of these cases. There were no significant differences between the durotomy and no-durotomy groups with respect to age, sex, race, body mass index, herniation level or type, or the prevalence of smoking, diabetes, or hypertension. When outcome differences between the groups were analyzed, the durotomy group was found to have significantly increased operative duration, operative blood loss, and length of inpatient stay. However, there were no significant differences in incidence rates for nerve root injury, postoperative mortality, additional surgeries, or SF-36 scores for Bodily Pain or Physical Function, or Oswestry Disability Index scores at 1, 2, 3, or 4 years. Conclusions Incidental durotomy during first-time lumbar discectomy does not appear to impact long-term outcome in affected patients.

Comparative analysis of neurological recovery and adverse effects in chondrodystrophic dogs with thoracolumbar intervertebral disc herniation treated with methylprednisolone versus non-steroidal anti-inflammatory drugs

2021 ◽  
Author(s):  
William McCartney ◽  
Ciprian Andrei Ober ◽  
Maria Benito
Keyword(s):  
Treatment Group ◽  
Side Effects ◽  
Intervertebral Disc ◽  
Disc Herniation ◽  
Sodium Succinate ◽  
Neurological Recovery ◽  
Intervertebral Disc Herniation ◽  
Cord Injury ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Thoracolumbar intervertebral disc herniation is a common neurologic disease presented to the small-animal practitioner. The use of methylprednisolone sodium succinate (MPSS) as an adjunct to surgical decompression in cases of acute spinal cord injury following intervertebral disc extrusion is controversial. A prospective study was undertaken to compare the preoperative use of MPSS and non-steroidal anti-inflammatory drugs (NSAIDs) in 40 chondrodystrophic dogs presenting with similar signs and undergoing spinal decompressive surgery. Twenty dogs received MPSS and 20 had NSAIDs administered preoperatively. Dogs were administered with either MPSS intravenously 20 minutes before surgery (30 mg/kg) or NSAID (meloxicam 0.2mg/kg or carprofen 4 mg/kg) subcutaneously 20 minutes before surgery. Dogs were evaluated by neurologic examination of gait 24 hours postoperatively, at time of discharge and then at 8 weeks. The neurological recovery were similar in both groups, but the frequency of side effects such as vomiting (MPSS group: 90% versus NSAIDs group: 55%), and anorexia within the first three days (present in all 20 dogs pretreated with MPSS) was significantly different, with complications being more prevalent in the MPSS group. Side effects were significantly more evident with MPSS treatment group –including vomiting and anorexia during the first 3 days after surgery– than with NSAID treatment group, with a neurological recovery similar in both groups.

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