Journal of veterinary internal medicine · 2026
Acute hydrated nucleus pulposus extrusion in dogs with severe neurologic status: comparison between conservative and surgical treatment.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Di Tosto Martin, Toni Cristina, Contiero Barbara, Cozzi Francesca, Marioni-Henry Katia, Menchetti Marika, Betti Barbara, Tirrito Federica
Аннотация
BACKGROUND: Hydrated nucleus pulposus extrusion (HNPE) is associated with favorable outcome after conservative or surgical treatment. However, optimal management for dogs with severe neurologic deficits remains unclear.
HYPOTHESIS/OBJECTIVES: Compare conservative vs surgical treatment in nonambulatory paretic or plegic dogs with HNPE, focusing on recovery of unassisted ambulation and voluntary urination, and identify prognostic factors.
ANIMALS: Eighty-six dogs with severe neurologic impairment and a presumptive magnetic resonance imaging (MRI) diagnosis of HNPE.
METHODS: Retrospective multicenter study. Signalment, neurologic grade, neurolocalization, MRI findings, and treatment were recorded. Outcome was assessed at 1 week, 4 weeks, and 6 months. Satisfactory outcome was defined as recovery of voluntary urination and independent ambulation. Recovery time was defined as days to regain unassisted ambulation.
RESULTS: Sixty dogs were treated conservatively and 26 surgically. Hydrated nucleus pulposus extrusion was cervical in 71/86 (83%) dogs and thoracolumbar in 15/86 (17%). At presentation, 62/86 (72%) dogs were nonambulatory paretic, 22/86 (26%) were plegic with intact nociception, and 2/86 (2%) were plegic without nociception. At 1 week, neurologic status was better in the conservative group than in the surgical group, whereas no differences were observed at later follow-up. Satisfactory outcome was achieved in 85% of conservatively treated and 100% of surgically treated dogs. Median recovery time was 7 days with conservative treatment and 9 days with surgery. Non-chondrodystrophic breed, MRI intramedullary T2-weighted hyperintensity, and physical therapy were associated with longer recovery.
CONCLUSIONS AND CLINICAL IMPORTANCE: Conservative treatment represents a valid option for nonambulatory dogs with HNPE. Signalment and MRI features should guide treatment selection.
HYPOTHESIS/OBJECTIVES: Compare conservative vs surgical treatment in nonambulatory paretic or plegic dogs with HNPE, focusing on recovery of unassisted ambulation and voluntary urination, and identify prognostic factors.
ANIMALS: Eighty-six dogs with severe neurologic impairment and a presumptive magnetic resonance imaging (MRI) diagnosis of HNPE.
METHODS: Retrospective multicenter study. Signalment, neurologic grade, neurolocalization, MRI findings, and treatment were recorded. Outcome was assessed at 1 week, 4 weeks, and 6 months. Satisfactory outcome was defined as recovery of voluntary urination and independent ambulation. Recovery time was defined as days to regain unassisted ambulation.
RESULTS: Sixty dogs were treated conservatively and 26 surgically. Hydrated nucleus pulposus extrusion was cervical in 71/86 (83%) dogs and thoracolumbar in 15/86 (17%). At presentation, 62/86 (72%) dogs were nonambulatory paretic, 22/86 (26%) were plegic with intact nociception, and 2/86 (2%) were plegic without nociception. At 1 week, neurologic status was better in the conservative group than in the surgical group, whereas no differences were observed at later follow-up. Satisfactory outcome was achieved in 85% of conservatively treated and 100% of surgically treated dogs. Median recovery time was 7 days with conservative treatment and 9 days with surgery. Non-chondrodystrophic breed, MRI intramedullary T2-weighted hyperintensity, and physical therapy were associated with longer recovery.
CONCLUSIONS AND CLINICAL IMPORTANCE: Conservative treatment represents a valid option for nonambulatory dogs with HNPE. Signalment and MRI features should guide treatment selection.