Journal of veterinary internal medicine · 2022
A 50-step walking test for analysis of recovery after decompressive surgery for thoracolumbar disc herniation in dogs.
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Rosen Suzanne, Grzegorzewski Jessica Lynn, Heath Stephanie, Schocke Cynthia, Jeffery Nicholas
Аннотация
BACKGROUND: Despite its importance, there is no agreed definition of recovery of ambulation in dogs with spinal cord injury.
OBJECTIVES: To validate a new walking test in dogs recovering from thoracolumbar spinal cord injury.
ANIMALS: Two hundred twenty-four dogs weighing <20 kg: 120 normally ambulatory dogs, plus 104 dogs undergoing decompressive surgery for acute thoracolumbar intervertebral disc herniation.
METHODS: Prospective cohort studies. The distance each freely-ambulatory dog walked during 50 step cycles was regressed on ulna length. For each postsurgical dog, we recorded when the calculated 50-step distance was completed without falling, or their inability to complete this distance by 4 months or more after surgery. Bayesian analysis compared outcomes for presurgical neurologic categories; association of recovery with several preoperative variables was explored using logistic and time-to-event regression.
RESULTS: For control dogs, 50-step distance (m) = 1.384 × ulnar length (cm) + 2.773. In postsurgical dogs, the 50-step test provided decisive evidence that deep pain-negative dogs were less likely to recover ambulation than dogs with intact pain perception (12/29 recovered vs 71/75; Bayes factor [BF] = 5.9 × 106 ) and, if they did recover, it took much longer (median 91 days vs median 14 days; BF = 1.5 × 103 ). Exploratory analysis suggested that presurgical neurologic status (subhazard ratio [SHR] = 0.022; P < .001) and duration of presurgical anesthesia (SHR = 0.740; P = .04) were associated with rapidity of recovery.
CONCLUSIONS AND CLINICAL IMPORTANCE: This straightforward 50-step walking test provides robust data on ambulatory recovery well-suited to large scale pragmatic trials on treatment of thoracolumbar spinal cord injury in dogs.
OBJECTIVES: To validate a new walking test in dogs recovering from thoracolumbar spinal cord injury.
ANIMALS: Two hundred twenty-four dogs weighing <20 kg: 120 normally ambulatory dogs, plus 104 dogs undergoing decompressive surgery for acute thoracolumbar intervertebral disc herniation.
METHODS: Prospective cohort studies. The distance each freely-ambulatory dog walked during 50 step cycles was regressed on ulna length. For each postsurgical dog, we recorded when the calculated 50-step distance was completed without falling, or their inability to complete this distance by 4 months or more after surgery. Bayesian analysis compared outcomes for presurgical neurologic categories; association of recovery with several preoperative variables was explored using logistic and time-to-event regression.
RESULTS: For control dogs, 50-step distance (m) = 1.384 × ulnar length (cm) + 2.773. In postsurgical dogs, the 50-step test provided decisive evidence that deep pain-negative dogs were less likely to recover ambulation than dogs with intact pain perception (12/29 recovered vs 71/75; Bayes factor [BF] = 5.9 × 106 ) and, if they did recover, it took much longer (median 91 days vs median 14 days; BF = 1.5 × 103 ). Exploratory analysis suggested that presurgical neurologic status (subhazard ratio [SHR] = 0.022; P < .001) and duration of presurgical anesthesia (SHR = 0.740; P = .04) were associated with rapidity of recovery.
CONCLUSIONS AND CLINICAL IMPORTANCE: This straightforward 50-step walking test provides robust data on ambulatory recovery well-suited to large scale pragmatic trials on treatment of thoracolumbar spinal cord injury in dogs.