scholarly journals Emerging and Adjunctive Therapies for Spinal Cord Injury Following Acute Canine Intervertebral Disc Herniation

2020 ◽  
Vol 7 ◽  
Author(s):  
Melissa J. Lewis ◽  
Nicolas Granger ◽  
Nick D. Jeffery ◽  

Some dogs do not make a full recovery following medical or surgical management of acute canine intervertebral disc herniation (IVDH), highlighting the limits of currently available treatment options. The multitude of difficulties in treating severe spinal cord injury are well-recognized, and they have spurred intense laboratory research, resulting in a broad range of strategies that might have value in treating spinal cord-injured dogs. These include interventions that aim to directly repair the spinal cord lesion, promote axonal sparing or regeneration, mitigate secondary injury through neuroprotective mechanisms, or facilitate functional compensation. Despite initial promise in experimental models, many of these techniques have failed or shown mild efficacy in clinical trials in humans and dogs, although high quality evidence is lacking for many of these interventions. However, the continued introduction of new options to the veterinary clinic remains important for expanding our understanding of the mechanisms of injury and repair and for development of novel and combined strategies for severely affected dogs. This review outlines adjunctive or emerging therapies that have been proposed as treatment options for dogs with acute IVDH, including discussion of local or lesion-based approaches as well as systemically applied treatments in both acute and subacute-to-chronic settings. These interventions include low-level laser therapy, electromagnetic fields or oscillating electrical fields, adjunctive surgical techniques (myelotomy or durotomy), systemically or locally-applied hypothermia, neuroprotective chemicals, physical rehabilitation, hyperbaric oxygen therapy, electroacupuncture, electrical stimulation of the spinal cord or specific peripheral nerves, nerve grafting strategies, 4-aminopyridine, chondroitinase ABC, and cell transplantation.

2020 ◽  
Vol 37 (18) ◽  
pp. 1991-1998 ◽  
Author(s):  
Natasha Olby ◽  
Emily Griffith ◽  
Jon Levine ◽  
Ronaldo da Costa ◽  
Joseph Fenn ◽  
...  

2018 ◽  
Vol 46 (05) ◽  
pp. 330-336
Author(s):  
Michael Fehr ◽  
Jasmin Neßler ◽  
Alexandra Schütter ◽  
Peter Dziallas ◽  
Viktor Molnár ◽  
...  

SummaryMagnetic resonance imaging revealed spinal cord compression due to intervertebral disc herniation of Hansen type I and II in the thoracolumbar vertebral column in two middle-aged coatis (Nasua nasua) with chronic progressive paraparesis. Surgical treatment included hemilaminectomy and partial corpectomy in one and dorsal laminectomy in the other coati. Both coatis recovered well after surgery. One showed unremarkable gait 6 and 15 months post surgery, while the other one suffered from recurrence of paraparesis leading to euthanasia because of deterioration of neurological signs 20 months after the first surgery. Necropsy revealed formation of a laminectomy membrane compressing the spinal cord. Histopathological signs of spinal cord injury and findings of degenerative processes in the intervertebral disc were comparable to those described in dogs. In conclusion, this case report shows for the first time that surgical intervention seems to be a useful and safe treatment in chronic intervertebral disc herniation in coatis, but relapses are possible.


2021 ◽  
pp. 153857442110024
Author(s):  
Rozina Yasmin Choudhury ◽  
Kamran Basharat ◽  
Syeda Anum Zahra ◽  
Tien Tran ◽  
Lara Rimmer ◽  
...  

Over the decades, the Frozen Elephant Trunk (FET) technique has gained immense popularity allowing simplified treatment of complex aortic pathologies. FET is frequently used to treat aortic conditions involving the distal aortic arch and the proximal descending aorta in a single stage. Surgical preference has recently changed from FET procedures being performed at Zone 3 to Zone 2. There are several advantages of Zone 2 FET over Zone 3 FET including reduction in spinal cord injury, visceral ischemia, neurological and cardiovascular sequelae. In addition, Zone 2 FET is a technically less complicated procedure. Literature on the comparison between Zone 3 and Zone 2 FET is scarce and primarily observational and anecdotal. Therefore, further research is warranted in this paradigm to substantiate current surgical treatment options for complex aortic pathologies. In this review, we explore literature surrounding FET and the reasons for the shift in surgical preference from Zone 3 to Zone 2.


2021 ◽  
Author(s):  
William McCartney ◽  
Ciprian Andrei Ober ◽  
Maria Benito

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.


2017 ◽  
Vol 11 (4) ◽  
pp. 661-674 ◽  
Author(s):  
Kwang-Sup Song ◽  
Jae Hwan Cho ◽  
Jae-Young Hong ◽  
Jae Hyup Lee ◽  
Hyun Kang ◽  
...  

<p>Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015. Among 2,313 potential studies of interest, 25 randomized controlled trials (RCTs) and 21 systematic reviews (SRs) were included in the analysis. The selection was decided based on the agreement of two orthopedic surgeons. There was a lack of evidence about medication for radiculopathy arising from disc herniation and stenosis, but intervention procedures, including epidural block, showed positive efficacy in radiculopathy and also limited efficacy in spinal stenosis. There was some evidence based on the short-term follow-up regarding surgery being superior to conservative treatments for radiculopathy and stenosis. There was limited evidence regarding the efficacy of pharmacological and electric or magnetic stimulation therapies for neuropathic pain after spinal cord injury. This review of RCTs and SRs with high-quality evidence found some evidence regarding the efficacy of various treatment modalities for neuropathic pain related specifically to spinal disorders. However, there is a need for much more supportive evidence.</p>


Author(s):  
Masato Kitagawa ◽  
Midori Okada ◽  
Kiichi Kanayama ◽  
Takeo Sakai

A 10-year-old male cross-breed dog was brought to Nihon University Animal Hospital with a history of acute onset of paralysis in the pelvic limbs 13 days previously. Magnetic resonance imaging revealed an intramedullary linear tract in the spinal cord at the thoracic vertebrae 12–13 region, which appeared hyperintense on T2-weighted images, but was hypointense and isointense on T1-weighted images when compared with normal parenchyma of the spinal cord. A hemilaminectomy was performed and a blob of what appeared to be fibrous tissue was found adhering to the surface of the dura mater. The diameter of the blob was about 4 mm. A durotomy was performed over the affected area and chondroid material was found within the spinal cord. Material from the nucleus pulposus penetrated the dura mater from the ventral aspect of the spinal cord in previously reported intramedullary intervertebral disc herniation cases, but, in this case, penetration occurred from the left ventrolateral aspect and progressed through to the right lateral aspect, forming a visible blob of what appeared to be fibrous tissue on the surface of the dura mater at the exit point. To the best of our knowledge, this was the first case report of an intramedullary intervertebral disc herniation originating from the ventrolateral aspect of the spinal cord in a dog.


1996 ◽  
Vol 09 (04) ◽  
pp. 177-178 ◽  
Author(s):  
R. Selcer ◽  
W. H. Adams ◽  
W. B. Thomas ◽  
B. E. Wilkens

SummaryThree middle-aged (6-8 years), intact male Dachshunds were admitted to the University of Tennessee Veterinary Teaching Hospital (UTVTH) with acute onset of back pain and pelvic limb paralysis.Physical examination of dog #1 revealed hyperaesthesia of the thoracolumbar spine. Superficial pain sensation was absent in the pelvic limbs, while deep pain sensation was intact. The cutaneous trunci (panniculus) reflex was absent caudal to the thoraco-lumbar region. Reflexes to the pelvic limbs were exaggerated.A myelogram showed dorsal deviation of the ventral contrast column and attenuation of the ventral and dorsal contrast columns at the T9-T10 disc space. A hemilaminectomy was performed from T9 to T10, and mineralized disc material was retrieved from the vertebral canal at T9-T10. The T9- T10 to L3-L4 disc spaces were fenestrated. Two weeks after surgery, superficial and deep pain sensation of the rearlimbs were present, but paralysis persisted. The animal was euthanatised at the owners’ request. A postmortem examination was not performed.Dog #2 displayed absent superficial pain sensation, and intact deep pain sensation of the pelvic limbs. Hyperaesthesia of the thoracolumbar region and hyperreflexia of the rear limbs were noted. Examination of the cutaneous trunci reflex was not performed. A myelogram revealed ventral extradural compression of the spinal cord at T9- T10. A T9-T10 hemilaminectomy revealed a large amount of extruded disc material, which was removed. The Tll- T12 to L4-L5 intervertebral discs were fenestrated. Forty-eight hours postoperatively, the patient regained voluntary motor function, and recovery was uneventful.Neurologic examination of dog #3 revealed absence of deep pain sensation in the pelvic limbs; duration of which was not known. Spinal radiographs and myelography revealed ventral extradural spinal cord compression at T9-T10 (Fig.). A right-sided hemilaminectomy at T9-T10 revealed a large amount of calcified disc material, ventral to the spinal cord. The T11-T12 through Ll- L2 intervertebral discs were fenestrated. Sixty days postoperatively, paralysis persisted and the dog was euthanatised. No postmortem examination was performed.Herniation of the T9-T10 intervertebral disc was diagnosed in three Dachshunds with acute paraplegia. The clinical diagnosis and surgical management of T9-T10 disc herniation are similar to that in the more common sites of disc herniation.


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