An update on practice patterns of North American and European veterinary neurology and surgery specialists for surgical management of acute canine thoracolumbar intervertebral disc extrusion.

IF 1.9 2区 农林科学 Q2 VETERINARY SCIENCES
S Moore, P Early, N Olby, B Hettlich
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引用次数: 0

Abstract

Objectives: A thorough understanding of common practice patterns in a particular specialty can help identify and design new interventions to improve care delivery and access to care. The goals of this study were to document current practice patterns among veterinary "neurologists" and small animal "surgeons" in the surgical management of acute canine thoracolumbar intervertebral disc extrusion, to compare approaches between these two groups and to discuss current results compared to those published in 2016.

Materials and methods: A web-based survey was distributed in October 2024 to collect responses from board-certified and regionally recognised neurology and surgery specialists in North America and Europe. Data were summarised using descriptive statistics. Chi-squared analysis assessed differences in response distribution between "neurologists" and "surgeons" for specific questions.

Results: A total of 385 survey responses were received. There was a significant difference in the distribution of responses related to caseload between specialties, where "surgeons" most reported 1 to 25 cases per year and "neurologists" most reported managing >100 cases per year. "Surgeons" and "neurologists" did not differ with respect to surgical recommendations based on the severity of neurologic signs. Eighty per cent of "neurologists" and 47% or "surgeons" reported performing concurrent fenestration at the time of surgical decompression. Compared to 2016, utilisation of methylprednisolone sodium succinate and performance of after-hours surgery were reduced in both groups.

Clinical significance: Results of the present survey indicate substantial shifts in practice patterns for surgical management of this disease, some in alignment with current literature and some not. Future work should focus on the comparison of clinical outcomes in dogs imaged with CT versus MRI. Results also suggest a continued lack of clinical equipoise around prognostic factors for recovery and risk factors for progressive myelomalacia, such that future prospective studies could help improve clinician confidence in these areas.

北美和欧洲兽医神经病学和外科专家对急性犬胸腰椎椎间盘突出症的外科治疗的最新实践模式。
目标:全面了解特定专业的常见实践模式有助于确定和设计新的干预措施,以改善护理服务和获得护理的机会。本研究的目的是记录兽医“神经科医生”和小动物“外科医生”在急性犬胸腰椎椎间盘突出症手术治疗中的当前实践模式,比较这两组的方法,并将当前结果与2016年发表的结果进行比较。材料和方法:一项基于网络的调查于2024年10月分发,以收集北美和欧洲委员会认证和区域认可的神经病学和外科专家的反馈。使用描述性统计对数据进行汇总。卡方分析评估了“神经科医生”和“外科医生”对特定问题的反应分布的差异。结果:共收到调查问卷385份。在不同专业的病例量相关的应答分布上存在显著差异,其中“外科医生”最多报告每年1 - 25例,而“神经科医生”最多报告每年处理100 - 100例。“外科医生”和“神经科医生”在基于神经系统症状严重程度的手术建议方面没有差异。80%的“神经科医生”和47%的“外科医生”报告在手术减压时进行了同步开窗。与2016年相比,两组的甲泼尼龙琥珀酸钠使用率和术后手术表现均有所下降。临床意义:本调查的结果表明,这种疾病的外科治疗的实践模式发生了实质性的变化,有些与目前的文献一致,有些则相反。未来的工作应该集中在狗的CT和MRI成像的临床结果的比较。研究结果还表明,对于进展性骨髓瘤的康复预后因素和危险因素,临床仍然缺乏平衡,因此,未来的前瞻性研究可以帮助提高临床医生对这些领域的信心。
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来源期刊
Journal of Small Animal Practice
Journal of Small Animal Practice 农林科学-兽医学
CiteScore
3.30
自引率
6.20%
发文量
117
审稿时长
12-24 weeks
期刊介绍: Journal of Small Animal Practice (JSAP) is a monthly peer-reviewed publication integrating clinical research papers and case reports from international sources, covering all aspects of medicine and surgery relating to dogs, cats and other small animals. These papers facilitate the dissemination and implementation of new ideas and techniques relating to clinical veterinary practice, with the ultimate aim of promoting best practice. JSAP publishes high quality original articles, as well as other scientific and educational information. New developments are placed in perspective, encompassing new concepts and peer commentary. The target audience is veterinarians primarily engaged in the practise of small animal medicine and surgery. In addition to original articles, JSAP will publish invited editorials (relating to a manuscript in the same issue or a topic of current interest), review articles, which provide in-depth discussion of important clinical issues, and other scientific and educational information from around the world. The final decision on publication of a manuscript rests with the Editorial Board and ultimately with the Editor. All papers, regardless of type, represent the opinion of the authors and not necessarily that of the Editor, the Association or the Publisher. The Journal of Small Animal Practice is published on behalf of the British Small Animal Veterinary Association and is also the official scientific journal of the World Small Animal Veterinary Association
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