Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs

Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Sarah A. Moore [verfasserIn] Andrea Tipold [verfasserIn] Natasha J. Olby [verfasserIn] Veronica Stein [verfasserIn] Nicolas Granger [verfasserIn] Canine Spinal Cord Injury Consortium (CANSORT SCI) [verfasserIn] Kady M. Gjessing [verfasserIn] Rhanna M. Davidson [verfasserIn] Jonathan M. Levine [verfasserIn] Helen McWhorter [verfasserIn] Melissa J. Lewis [verfasserIn] Nick D. Jeffery [verfasserIn] Maureen E Mullins [verfasserIn] Ronaldo Casimiro da Costa [verfasserIn] Yvette S. Nout-Lomas [verfasserIn] Joe Fenn [verfasserIn] Ingo Spitzbarth [verfasserIn] Veronika M. Stein [verfasserIn] Ji-Hey Lim [verfasserIn] Holger Volk [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	dog interveterbral disc intervertebral disc disease hemilaminectomy spinal cord injury hansen type I

Übergeordnetes Werk:	In: Frontiers in Veterinary Science - Frontiers Media S.A., 2015, 7(2020)
Übergeordnetes Werk:	volume:7 ; year:2020

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3389/fvets.2020.00610

Katalog-ID:	DOAJ046197141

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allfields	10.3389/fvets.2020.00610 doi (DE-627)DOAJ046197141 (DE-599)DOAJ43842fc7ece047358a84175ace505a92 DE-627 ger DE-627 rakwb eng SF600-1100 Sarah A. Moore verfasserin aut Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation. dog interveterbral disc intervertebral disc disease hemilaminectomy spinal cord injury hansen type I Veterinary medicine Andrea Tipold verfasserin aut Natasha J. Olby verfasserin aut Veronica Stein verfasserin aut Nicolas Granger verfasserin aut Nicolas Granger verfasserin aut Canine Spinal Cord Injury Consortium (CANSORT SCI) verfasserin aut Sarah A. Moore verfasserin aut Natasha J. Olby verfasserin aut Kady M. Gjessing verfasserin aut Rhanna M. Davidson verfasserin aut Jonathan M. Levine verfasserin aut Helen McWhorter verfasserin aut Melissa J. Lewis verfasserin aut Nick D. Jeffery verfasserin aut Maureen E Mullins verfasserin aut Ronaldo Casimiro da Costa verfasserin aut Yvette S. Nout-Lomas verfasserin aut Joe Fenn verfasserin aut Nicolas Granger verfasserin aut Ingo Spitzbarth verfasserin aut Veronika M. Stein verfasserin aut Andrea Tipold verfasserin aut Ji-Hey Lim verfasserin aut Holger Volk verfasserin aut In Frontiers in Veterinary Science Frontiers Media S.A., 2015 7(2020) (DE-627)835029417 (DE-600)2834243-4 22971769 nnns volume:7 year:2020 https://doi.org/10.3389/fvets.2020.00610 kostenfrei https://doaj.org/article/43842fc7ece047358a84175ace505a92 kostenfrei https://www.frontiersin.org/article/10.3389/fvets.2020.00610/full kostenfrei https://doaj.org/toc/2297-1769 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
spelling	10.3389/fvets.2020.00610 doi (DE-627)DOAJ046197141 (DE-599)DOAJ43842fc7ece047358a84175ace505a92 DE-627 ger DE-627 rakwb eng SF600-1100 Sarah A. Moore verfasserin aut Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation. dog interveterbral disc intervertebral disc disease hemilaminectomy spinal cord injury hansen type I Veterinary medicine Andrea Tipold verfasserin aut Natasha J. Olby verfasserin aut Veronica Stein verfasserin aut Nicolas Granger verfasserin aut Nicolas Granger verfasserin aut Canine Spinal Cord Injury Consortium (CANSORT SCI) verfasserin aut Sarah A. Moore verfasserin aut Natasha J. Olby verfasserin aut Kady M. Gjessing verfasserin aut Rhanna M. Davidson verfasserin aut Jonathan M. Levine verfasserin aut Helen McWhorter verfasserin aut Melissa J. Lewis verfasserin aut Nick D. Jeffery verfasserin aut Maureen E Mullins verfasserin aut Ronaldo Casimiro da Costa verfasserin aut Yvette S. Nout-Lomas verfasserin aut Joe Fenn verfasserin aut Nicolas Granger verfasserin aut Ingo Spitzbarth verfasserin aut Veronika M. Stein verfasserin aut Andrea Tipold verfasserin aut Ji-Hey Lim verfasserin aut Holger Volk verfasserin aut In Frontiers in Veterinary Science Frontiers Media S.A., 2015 7(2020) (DE-627)835029417 (DE-600)2834243-4 22971769 nnns volume:7 year:2020 https://doi.org/10.3389/fvets.2020.00610 kostenfrei https://doaj.org/article/43842fc7ece047358a84175ace505a92 kostenfrei https://www.frontiersin.org/article/10.3389/fvets.2020.00610/full kostenfrei https://doaj.org/toc/2297-1769 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
allfields_unstemmed	10.3389/fvets.2020.00610 doi (DE-627)DOAJ046197141 (DE-599)DOAJ43842fc7ece047358a84175ace505a92 DE-627 ger DE-627 rakwb eng SF600-1100 Sarah A. Moore verfasserin aut Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation. dog interveterbral disc intervertebral disc disease hemilaminectomy spinal cord injury hansen type I Veterinary medicine Andrea Tipold verfasserin aut Natasha J. Olby verfasserin aut Veronica Stein verfasserin aut Nicolas Granger verfasserin aut Nicolas Granger verfasserin aut Canine Spinal Cord Injury Consortium (CANSORT SCI) verfasserin aut Sarah A. Moore verfasserin aut Natasha J. Olby verfasserin aut Kady M. Gjessing verfasserin aut Rhanna M. Davidson verfasserin aut Jonathan M. Levine verfasserin aut Helen McWhorter verfasserin aut Melissa J. Lewis verfasserin aut Nick D. Jeffery verfasserin aut Maureen E Mullins verfasserin aut Ronaldo Casimiro da Costa verfasserin aut Yvette S. Nout-Lomas verfasserin aut Joe Fenn verfasserin aut Nicolas Granger verfasserin aut Ingo Spitzbarth verfasserin aut Veronika M. Stein verfasserin aut Andrea Tipold verfasserin aut Ji-Hey Lim verfasserin aut Holger Volk verfasserin aut In Frontiers in Veterinary Science Frontiers Media S.A., 2015 7(2020) (DE-627)835029417 (DE-600)2834243-4 22971769 nnns volume:7 year:2020 https://doi.org/10.3389/fvets.2020.00610 kostenfrei https://doaj.org/article/43842fc7ece047358a84175ace505a92 kostenfrei https://www.frontiersin.org/article/10.3389/fvets.2020.00610/full kostenfrei https://doaj.org/toc/2297-1769 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
allfieldsGer	10.3389/fvets.2020.00610 doi (DE-627)DOAJ046197141 (DE-599)DOAJ43842fc7ece047358a84175ace505a92 DE-627 ger DE-627 rakwb eng SF600-1100 Sarah A. Moore verfasserin aut Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation. dog interveterbral disc intervertebral disc disease hemilaminectomy spinal cord injury hansen type I Veterinary medicine Andrea Tipold verfasserin aut Natasha J. Olby verfasserin aut Veronica Stein verfasserin aut Nicolas Granger verfasserin aut Nicolas Granger verfasserin aut Canine Spinal Cord Injury Consortium (CANSORT SCI) verfasserin aut Sarah A. Moore verfasserin aut Natasha J. Olby verfasserin aut Kady M. Gjessing verfasserin aut Rhanna M. Davidson verfasserin aut Jonathan M. Levine verfasserin aut Helen McWhorter verfasserin aut Melissa J. Lewis verfasserin aut Nick D. Jeffery verfasserin aut Maureen E Mullins verfasserin aut Ronaldo Casimiro da Costa verfasserin aut Yvette S. Nout-Lomas verfasserin aut Joe Fenn verfasserin aut Nicolas Granger verfasserin aut Ingo Spitzbarth verfasserin aut Veronika M. Stein verfasserin aut Andrea Tipold verfasserin aut Ji-Hey Lim verfasserin aut Holger Volk verfasserin aut In Frontiers in Veterinary Science Frontiers Media S.A., 2015 7(2020) (DE-627)835029417 (DE-600)2834243-4 22971769 nnns volume:7 year:2020 https://doi.org/10.3389/fvets.2020.00610 kostenfrei https://doaj.org/article/43842fc7ece047358a84175ace505a92 kostenfrei https://www.frontiersin.org/article/10.3389/fvets.2020.00610/full kostenfrei https://doaj.org/toc/2297-1769 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
allfieldsSound	10.3389/fvets.2020.00610 doi (DE-627)DOAJ046197141 (DE-599)DOAJ43842fc7ece047358a84175ace505a92 DE-627 ger DE-627 rakwb eng SF600-1100 Sarah A. Moore verfasserin aut Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation. dog interveterbral disc intervertebral disc disease hemilaminectomy spinal cord injury hansen type I Veterinary medicine Andrea Tipold verfasserin aut Natasha J. Olby verfasserin aut Veronica Stein verfasserin aut Nicolas Granger verfasserin aut Nicolas Granger verfasserin aut Canine Spinal Cord Injury Consortium (CANSORT SCI) verfasserin aut Sarah A. Moore verfasserin aut Natasha J. Olby verfasserin aut Kady M. Gjessing verfasserin aut Rhanna M. Davidson verfasserin aut Jonathan M. Levine verfasserin aut Helen McWhorter verfasserin aut Melissa J. Lewis verfasserin aut Nick D. Jeffery verfasserin aut Maureen E Mullins verfasserin aut Ronaldo Casimiro da Costa verfasserin aut Yvette S. Nout-Lomas verfasserin aut Joe Fenn verfasserin aut Nicolas Granger verfasserin aut Ingo Spitzbarth verfasserin aut Veronika M. Stein verfasserin aut Andrea Tipold verfasserin aut Ji-Hey Lim verfasserin aut Holger Volk verfasserin aut In Frontiers in Veterinary Science Frontiers Media S.A., 2015 7(2020) (DE-627)835029417 (DE-600)2834243-4 22971769 nnns volume:7 year:2020 https://doi.org/10.3389/fvets.2020.00610 kostenfrei https://doaj.org/article/43842fc7ece047358a84175ace505a92 kostenfrei https://www.frontiersin.org/article/10.3389/fvets.2020.00610/full kostenfrei https://doaj.org/toc/2297-1769 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
language	English
source	In Frontiers in Veterinary Science 7(2020) volume:7 year:2020
sourceStr	In Frontiers in Veterinary Science 7(2020) volume:7 year:2020
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	dog interveterbral disc intervertebral disc disease hemilaminectomy spinal cord injury hansen type I Veterinary medicine
isfreeaccess_bool	true
container_title	Frontiers in Veterinary Science
authorswithroles_txt_mv	Sarah A. Moore @@aut@@ Andrea Tipold @@aut@@ Natasha J. Olby @@aut@@ Veronica Stein @@aut@@ Nicolas Granger @@aut@@ Canine Spinal Cord Injury Consortium (CANSORT SCI) @@aut@@ Kady M. Gjessing @@aut@@ Rhanna M. Davidson @@aut@@ Jonathan M. Levine @@aut@@ Helen McWhorter @@aut@@ Melissa J. Lewis @@aut@@ Nick D. Jeffery @@aut@@ Maureen E Mullins @@aut@@ Ronaldo Casimiro da Costa @@aut@@ Yvette S. Nout-Lomas @@aut@@ Joe Fenn @@aut@@ Ingo Spitzbarth @@aut@@ Veronika M. Stein @@aut@@ Ji-Hey Lim @@aut@@ Holger Volk @@aut@@
publishDateDaySort_date	2020-01-01T00:00:00Z
hierarchy_top_id	835029417
id	DOAJ046197141
language_de	englisch
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spellingShingle	Sarah A. Moore misc SF600-1100 misc dog misc interveterbral disc misc intervertebral disc disease misc hemilaminectomy misc spinal cord injury misc hansen type I misc Veterinary medicine Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs
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topic_title	SF600-1100 Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs dog interveterbral disc intervertebral disc disease hemilaminectomy spinal cord injury hansen type I
topic	misc SF600-1100 misc dog misc interveterbral disc misc intervertebral disc disease misc hemilaminectomy misc spinal cord injury misc hansen type I misc Veterinary medicine
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title	Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs
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title_full	Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs
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author_browse	Sarah A. Moore Andrea Tipold Natasha J. Olby Veronica Stein Nicolas Granger Canine Spinal Cord Injury Consortium (CANSORT SCI) Kady M. Gjessing Rhanna M. Davidson Jonathan M. Levine Helen McWhorter Melissa J. Lewis Nick D. Jeffery Maureen E Mullins Ronaldo Casimiro da Costa Yvette S. Nout-Lomas Joe Fenn Ingo Spitzbarth Veronika M. Stein Ji-Hey Lim Holger Volk
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title_sort	current approaches to the management of acute thoracolumbar disc extrusion in dogs
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title_auth	Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs
abstract	Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation.
abstractGer	Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation.
abstract_unstemmed	Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation.
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title_short	Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs
url	https://doi.org/10.3389/fvets.2020.00610 https://doaj.org/article/43842fc7ece047358a84175ace505a92 https://www.frontiersin.org/article/10.3389/fvets.2020.00610/full https://doaj.org/toc/2297-1769
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