Loss Of Deep Pain Sensation Research Articles

Extended durotomy to treat severe spinal cord injury after acute thoracolumbar disc herniation in dogs.

To report recovery of ambulation of dogs treated with extended thoracolumbar durotomy for severe spinal cord injury caused by intervertebral disc herniation. Descriptive cohort. Twenty-six consecutive paraplegic dogs presented with loss of deep pain sensation after acute thoracolumbar intervertebral disc herniation. Each dog underwent routine diagnostic assessment and surgery for removal of extradural herniated intervertebral disc, followed by a four-vertebral body length durotomy centered on the herniated disc. Each dog was followed up until it was able to walk 10 steps without assistance or until 6 months after surgery. Sixteen of 26 dogs recovered to walk unaided (all but one also recovered fecal and urinary continence), and six dogs did not; four dogs were lost to follow-up. One dog was euthanized because of signs consistent with progressive myelomalacia. There was no evidence of detrimental effects of durotomy within the period of study. Using Bayesian analysis, we found a point estimate of successful outcome of 71% with 95% credible interval from 52% to 87%. Extended durotomy seemed to improve the outcome of dogs in our case series without increase in morbidity. Extended durotomy appears safe and may improve the outcome of dogs with severe thoracolumbar mixed contusion and compressive injuries associated with acute intervertebral disc extrusion.

Vertebral Fractures and Luxation in Dogs

Background: Vertebral fractures and luxations (VFL) are a major cause of neurologic injury in small animals. They are most commonly associated with severe external trauma from road traffic accidents, aggression, or falls from heights. There were few studies concerning VFL, mainly on results of treatments and sequelae. This retrospective work aimed to study patients with extrinsic trauma in the spinal cord that were treated at the Neurology and Neurosurgery Service of a Higher Education Institution in Brazil from 2007 to 2018, describing main etiologies, location of lesion, degree of neurological dysfunction, treatment, and results and sequelae after surgical or conservative therapy.Materials, Methods & Results: One hundred and nine dogs of various breed and ages were included in this study. The main etiology of the spinal cord injury in these dogs were fractures and/or dislocations caused by road traffic accidents (66%), followed by interaction with other animals (5.5%). The body region most frequently affected by the lesions were the thoracolumbar segment (T3-L3) of the vertebral spine (52.3%), followed the lumbosacral segment [L4-S3] (54.8%). The degrees of the most prevalent neurological dysfunctions for each of the segments were grade V in 73.7% of the dogs with lesions between T3-L3, and grade III in 54.8% of the dogs with lesions in L4-S3. Twenty-one tutors of dogs subjected to surgery and 20 tutors of dogs that underwent clinical treatment could be contacted by phone. Statistical analysis performed on data from these patients indicated that there was no significant correlation between the motor recovery and the type of treatment instituted. However, when the degree of motor dysfunction was analyzed in conjunction with recovery, milder grades were found to be accompanied by the best recovery results.Discussion: Road traffic accidents were the most common cause of damage to the spinal cord, a finding described in other studies on extrinsic trauma. Due to the retrospective nature of this study, the analysis of the patients' motor recovery was performed using data from only 41 patients whose tutors could be reached by phone. We found that, in dogs that had satisfactory or partially satisfactory recovery, the ability to walk was restored between two and six months independent of the type of treatment (clinical or surgical). The criteria taken into account to choose the therapeutic option were degree of neurological dysfunction and/or presence of vertebral instability based on the three-compartment theory and the choice of the tutor after information on prognosis, postoperative care, possible neurological sequelae, and costs. Even though rigid external immobilization is indicated for the conservative treatment of VFL, in this study, all dogs subjected to clinical treatment were kept in cages without the use of external immobilization. Rigid immobilization causes discomfort to the patient, as well as complications during use. Loss of deep pain sensation (nociception) may occur immediately after acute injury, and it may be recovered after stabilization. In some cases, patients may experience urinary and/or fecal incontinence. Urinary and/or fecal incontinence was the main sequela reported by tutors, and was the main reason for euthanasia of surviving patients. We believe that further studies on this subject are necessary in order to gather information that can be used to provide better assistance for future patients affected by medullary trauma due to extrinsic factors.

‘Bottom-hung window’ trauma in cats: neurological evaluation and outcome in 71 cats with bilateral hindlimb injury

ObjectivesInfluence of neurological status on the mortality rate of paraparetic/paralysed cats presenting after entrapment in a bottom-hung window was evaluated. It was hypothesised that (1) loss of deep pain sensation...

Percutaneous transplantation of human umbilical cord-derived mesenchymal stem cells in a dog suspected to have fibrocartilaginous embolic myelopathy

The use of human umbilical cord blood-derived mesenchymal stem cells for cell transplantation therapy holds great promise for repairing spinal cord injury. Here we report the first clinical trial transplantation of human umbilical cord (hUCB)-derived mesenchymal stem cells (MSCs) into the spinal cord of a dog suspected to have fibrocartilaginous embolic myelopathy (FCEM) and that experienced a loss of deep pain sensation. Locomotor functions improved following transplantation in a dog. Based on our findings, we suggest that transplantation of hUCB-derived MSCs will have beneficial therapeutic effects on FCEM patients lacking deep pain sensation.

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Survival rates and outcomes in cats with thoracic and lumbar spinal cord injuries due to external trauma.

Survival rates and outcome were retrospectively examined in 30 cats with traumatic spinal cord lesions to the thoracic and lumbar spine. Treatment included both surgical and non-surgical management. In cats with loss of deep pain sensation, a high incidence of myelomalacia was found during surgery or postmortem examination. The outcome in cats with grade II and III neurological dysfunction (11/18) was poor in two cases, functional in one and complete in eight. Recovery in cats with grade IV neurological dysfunctions (7/18) was poor in one case, functional in two and complete in four. The other 12 of the original 30 cats were euthanased within four days of presentation. The results of this study are compared with those reported in cats with spinal injuries due to spontaneous disc herniations and to those that have been achieved in cats with experimental transections of the spinal cord.