Investigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion: a retrospective study of 1501 cases
Abstract Background Intervertebral disc extrusions in the thoracolumbar region are a common spinal neurologic disorder in dogs and usually considered a neurological emergency. Several factors, like timing of surgery, have previously been analysed in order to determine the effect on outcome and time...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Acta Veterinaria Scandinavica |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13028-021-00596-w |
| _version_ | 1819109325687226368 |
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| author | Almut Immekeppel Stefan Rupp Stanislas Demierre Kai Rentmeister Andrea Meyer-Lindenberg Julia Goessmann Monty Siddartha Bali Fenella Schmidli-Davies Franck Forterre |
| author_facet | Almut Immekeppel Stefan Rupp Stanislas Demierre Kai Rentmeister Andrea Meyer-Lindenberg Julia Goessmann Monty Siddartha Bali Fenella Schmidli-Davies Franck Forterre |
| author_sort | Almut Immekeppel |
| collection | DOAJ |
| description | Abstract Background Intervertebral disc extrusions in the thoracolumbar region are a common spinal neurologic disorder in dogs and usually considered a neurological emergency. Several factors, like timing of surgery, have previously been analysed in order to determine the effect on outcome and time of recovery. Most studies have investigated one defined population of dogs and the influence of a single factor on the overall outcome. In this retrospective study, a large cohort of dogs and the influence of one or combinations of several factors on outcome and time of recovery were analysed. Results The bivariate analysis demonstrated a significant association between the following variables and the time of recovery: the time span between the onset of clinical signs and surgery (Cramers Phi $$\varphi^{\prime}$$ φ ′ = 0.14; P = 0.003), the grade of severity ( $$\varphi^{\prime}$$ φ ′ = 0.23; P < 0.001) and the implementation of physical rehabilitation ( $$\varphi^{\prime}$$ φ ′ = 0.2; P < 0.001). However, the analysis of a multivariable regression model demonstrated that a significant correlation only exists between the time span between the onset of clinical signs and surgery and the overall outcome (P = 0.007), as well as between the grade of severity and the time of recovery (P < 0.001). The percentage of dogs with lacking deep pain perception (DPP) that had to be euthanised due to their neurological condition, decreased from 20.0 to 2.9% when physical rehabilitation was implemented. Additionally, the proportion of dogs (same group) that improved to reach an ambulatory status increased from 80.0 to 91.4%. Conclusion The results of the bivariate analysis demonstrated several correlations between some variables and overall outcome or time of recovery, whereas the multivariable regression model demonstrated only two associations. The time span between the onset of clinical signs and surgery was significantly associated with the overall outcome. We therefore suggest that a surgical intervention should be performed without unreasonable delay. Due to the correlation between the grade of severity and time of recovery, owners of dogs with more severe neurological deficits prior to surgery should be informed about the presumably prolonged time of recovery. |
| first_indexed | 2024-12-22T03:24:02Z |
| format | Article |
| id | doaj.art-153dff0723884888972c079ad3872b1e |
| institution | Directory Open Access Journal |
| issn | 1751-0147 |
| language | English |
| last_indexed | 2024-12-22T03:24:02Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Acta Veterinaria Scandinavica |
| spelling | doaj.art-153dff0723884888972c079ad3872b1e2022-12-21T18:40:39ZengBMCActa Veterinaria Scandinavica1751-01472021-08-0163111010.1186/s13028-021-00596-wInvestigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion: a retrospective study of 1501 casesAlmut Immekeppel0Stefan Rupp1Stanislas Demierre2Kai Rentmeister3Andrea Meyer-Lindenberg4Julia Goessmann5Monty Siddartha Bali6Fenella Schmidli-Davies7Franck Forterre8Department of Clinical Veterinary Science, Vetsuisse-Faculty, Small Animal Clinic, University of BernTierklinik Hofheim, Small Animal ClinicNeurologie Veterinaire, Small Animal PracticeTieraerztliche Praxis für Neurologie, Small Animal PracticeDepartment of Clinical Veterinary Sciences, Small Animal Clinic for Surgery and Gynecology, Ludwig-Maximilian-University-MunichDepartment of Clinical Veterinary Sciences, Small Animal Clinic for Surgery and Gynecology, Ludwig-Maximilian-University-MunichTierklinik StommelnDepartment of Clinical Veterinary Science, Vetsuisse-Faculty, Small Animal Clinic, University of BernDepartment of Clinical Veterinary Science, Vetsuisse-Faculty, Small Animal Clinic, University of BernAbstract Background Intervertebral disc extrusions in the thoracolumbar region are a common spinal neurologic disorder in dogs and usually considered a neurological emergency. Several factors, like timing of surgery, have previously been analysed in order to determine the effect on outcome and time of recovery. Most studies have investigated one defined population of dogs and the influence of a single factor on the overall outcome. In this retrospective study, a large cohort of dogs and the influence of one or combinations of several factors on outcome and time of recovery were analysed. Results The bivariate analysis demonstrated a significant association between the following variables and the time of recovery: the time span between the onset of clinical signs and surgery (Cramers Phi $$\varphi^{\prime}$$ φ ′ = 0.14; P = 0.003), the grade of severity ( $$\varphi^{\prime}$$ φ ′ = 0.23; P < 0.001) and the implementation of physical rehabilitation ( $$\varphi^{\prime}$$ φ ′ = 0.2; P < 0.001). However, the analysis of a multivariable regression model demonstrated that a significant correlation only exists between the time span between the onset of clinical signs and surgery and the overall outcome (P = 0.007), as well as between the grade of severity and the time of recovery (P < 0.001). The percentage of dogs with lacking deep pain perception (DPP) that had to be euthanised due to their neurological condition, decreased from 20.0 to 2.9% when physical rehabilitation was implemented. Additionally, the proportion of dogs (same group) that improved to reach an ambulatory status increased from 80.0 to 91.4%. Conclusion The results of the bivariate analysis demonstrated several correlations between some variables and overall outcome or time of recovery, whereas the multivariable regression model demonstrated only two associations. The time span between the onset of clinical signs and surgery was significantly associated with the overall outcome. We therefore suggest that a surgical intervention should be performed without unreasonable delay. Due to the correlation between the grade of severity and time of recovery, owners of dogs with more severe neurological deficits prior to surgery should be informed about the presumably prolonged time of recovery.https://doi.org/10.1186/s13028-021-00596-wAcute deteriorationGrade of severityIntervertebral disc extrusionLoss of deep pain perceptionPhysical rehabilitationTime of recovery |
| spellingShingle | Almut Immekeppel Stefan Rupp Stanislas Demierre Kai Rentmeister Andrea Meyer-Lindenberg Julia Goessmann Monty Siddartha Bali Fenella Schmidli-Davies Franck Forterre Investigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion: a retrospective study of 1501 cases Acta Veterinaria Scandinavica Acute deterioration Grade of severity Intervertebral disc extrusion Loss of deep pain perception Physical rehabilitation Time of recovery |
| title | Investigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion: a retrospective study of 1501 cases |
| title_full | Investigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion: a retrospective study of 1501 cases |
| title_fullStr | Investigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion: a retrospective study of 1501 cases |
| title_full_unstemmed | Investigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion: a retrospective study of 1501 cases |
| title_short | Investigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion: a retrospective study of 1501 cases |
| title_sort | investigation of timing of surgery and other factors possibly influencing outcome in dogs with acute thoracolumbar disc extrusion a retrospective study of 1501 cases |
| topic | Acute deterioration Grade of severity Intervertebral disc extrusion Loss of deep pain perception Physical rehabilitation Time of recovery |
| url | https://doi.org/10.1186/s13028-021-00596-w |
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