Comparison of the Efficacy of Surgical Decompression Alone and Combined With Canine Adipose Tissue-Derived Stem Cell Transplantation in Dogs With Acute Thoracolumbar Disk Disease and Spinal Cord Injury.

Fernando Swiech Bach,Fabiano Montiani-Ferreira,Carmen Lucia Kuniyoshi Rebelatto,Paulo Roberto Slud Brofman,Jair Rodini Engracia Filho,Claudia Turra Pimpão,Alexandra Cristina Senegaglia,Debora Regina Daga,Felipe Yukio Ishikawa Fragoso,José Ademar Villanova,Leticia Fracaro

doi:10.3389/fvets.2019.00383

Abstract

Paraparesis and paraplegia are common conditions in dogs, most often caused by a disc herniation in the thoracolumbar spinal segments (T3-L3), which is a neurological emergency. Surgical decompression should be performed as soon as possible when spinal compression is revealed by myelography, computed tomography, or magnetic resonance imaging. Mesenchymal stem-cell therapy is a promising adjunct treatment for spinal cord injury. This study sought to compare the effects of surgical decompression alone and combined with an allogeneic transplantation of canine adipose tissue-derived mesenchymal stem cells (cAd-MSCs) in the treatment of dogs with acute paraplegia. Twenty-two adult dogs of different breeds with acute paraplegia resulting from a Hansen type I disc herniation in the thoracolumbar region (T3-L3) were evaluated using computed tomography. All dogs had grade IV or V lesions and underwent surgery within 7 days after symptom onset. They were randomly assigned into two groups, 11 dogs in each. The dogs in Group I underwent hemilaminectomy, and those in Group II underwent hemilaminectomy and cAd-MSC epidural transplantation. In both groups, all dogs with grade IV lesions recovered locomotion. The median locomotion recovery period was 7 days for Group II and 21 days for Group I, and this difference was statistically significant (p < 0.05). Moreover, the median length of hospitalization after the surgery was statistically different between the two groups (Group I, 4 days; Group II, 3 days; p < 0.05). There were no statistically significant between-group differences regarding the number of animals with grade IV or V lesions that recovered locomotion and nociception. In conclusion, compared with surgical decompression alone, the use of epidural cAd-MSC transplantation with surgical decompression may contribute to faster locomotor recovery in dogs with acute paraplegia and reduce the length of post-surgery hospitalization.

Highlights

One of the most common causes of neurological disease in dogs is spinal compression secondary to disc disease, in the thoracolumbar segments (T3-L3)
We aimed to determine whether the transplant of epidural allogeneic cAdMSCs could aid Spinal cord injury (SCI) recovery in these dogs
These dogs had an acute thoracolumbar SCI secondary to a Hansen type I disc herniation that was confirmed by computed tomography (CT) (Figure 1)

Summary

Introduction

One of the most common causes of neurological disease in dogs is spinal compression secondary to disc disease, in the thoracolumbar segments (T3-L3). Spinal cord injury (SCI) may result from extrinsic factors, such as falls, fights, kicks, or ballistic projectiles, which can cause fractures and vertebral luxations, or may be secondary to intrinsic factors, such as neoplasms, fibrocartilaginous emboli, or disc herniations [1, 2]. Primary SCI occurs at the time of trauma and ranges from a small injury, caused by a minimal disc herniation into the vertebral canal, to large contusions and a severe spinal cord compression. Secondary lesions may occur within hours to days after the primary lesion These lesions are associated with a destructive cascade triggering systemic, local, and cellular events that progress to ischemia, hypoxia, edema, and various biochemical events that damage the spinal cord [4]

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