Post-surgical outcome and recurrence rates in thoracolumbar arachnoid diverticula undergoing durotomy alone or alongside a modified technique of subdural shunt-placement in dogs.
Sergio A Gomes, Mike Targett, Thomas Mignan, Sara Longo, Matthew James, Kimberley Stee, Hana Gunovska, Duarte Costa, Joana Diogo, Imogen Schofield, Mark Lowrie
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引用次数: 0
Abstract
Objective: The aims of this study were two-fold. First, to describe a modified technique of subdural shunt (SDS) placement for canine thoracolumbar arachnoid diverticula (TL-AD). Second, to compare outcome and recurrence of dogs following durotomy and debridement of meningeal attachments alone or in combination with SDS.
Animals: A total of 27 surgically managed TL-AD affected dogs.
Study design: Retrospective non-randomized descriptive case series.
Methods: Magnetic resonance imaging (MRI) TL-AD diagnosed dogs undergoing surgery, with 4-8 weeks postoperative recheck and follow-up time of >6 months. Two groups were compared: a control group, where durotomy and debridement of subdural adhesions alone was performed; a shunting group (SG) where SDS was utilized. The surgical technique was adapted from Meren et al., differing in access (hemilaminectomy), incision shape (longitudinal) and no suturing of the SDS or dura.
Results: A total of 12 dogs were included in the control group and 14 in the SG. One case, excluded, developed suspected postoperative surgical infection that resolved when the SDS was removed. Immediate postoperative and short-term outcome was not significantly different between groups. In the SG, long-term outcome was significantly better with dogs having improved neurologically (85.7% vs. 41.7%), and the rate of recurrence was lower (14.3% vs. 41.7%) although this last difference was not statistically significant (p = .19). Recurrence occurred at a median of 36 months from surgery (9-62), 5/7 recurrent cases were Pugs.
Conclusion: The adapted technique was successful in addressing TL-AD associated neurological signs in the long-term, as well as reducing recurrence of TL-AD.
Clinical significance: Shunt-placement appears to have a positive role in outcome and possibly recurrence prevention in cases of TL-AD.
期刊介绍：
Veterinary Surgery, the official publication of the American College of Veterinary Surgeons and European College of Veterinary Surgeons, is a source of up-to-date coverage of surgical and anesthetic management of animals, addressing significant problems in veterinary surgery with relevant case histories and observations.
It contains original, peer-reviewed articles that cover developments in veterinary surgery, and presents the most current review of the field, with timely articles on surgical techniques, diagnostic aims, care of infections, and advances in knowledge of metabolism as it affects the surgical patient. The journal places new developments in perspective, encompassing new concepts and peer commentary to help better understand and evaluate the surgical patient.
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