N04 - Comparison of Surgical Outcomes Associated with Compression Secondary to Hemorrhage and Intervertebral Disk Extrusions in Dogs

Abstract: Background –




A subset of intervertebral disk extrusion (IVDE) cases has compressive, hemorrhagic inflammation within the epidural space in addition to compression from the herniated disk material. We term this hemorrhagic extradural longitudinal parenchymal (HELP) compression. Previous reports have been conflicting in the outcomes of these cases.




Hypothesis/Objectives –




The goals are to compare success of surgical decompression in dogs with HELP compression compared to Modified Frankel Score (MFS) matched control dogs with non-hemorrhagic disk extrusions, evaluate the extent of spinal cord compression on MRI compared to final patient outcomes in HELP compression, and determine the compression to decompression ratio and its relation to outcomes in HELP cases.




Animals-




143 dogs from the neurology service were included: HELP compression dogs (n=65) and IVDE dogs (n=78).




Methods –




This is a retrospective case-control cross-sectional study. Each case was assigned an MFS on admission and follow-up. MRIs were reviewed and compression to decompression ratios were calculated based on T2 sagittal MRI images. Outcomes were assigned for each patient based on MFS at follow-up.




Results –




Outcomes of HELP and IVDE did not differ when taken to surgery when stratified by MFS. Dogs with HELP compression had more compressed sites than IVDE (P = 0.001) and had more sites decompressed (P < 0.001). Compression to decompression ratio did not differ between groups (P = 0.52) and their outcomes were not significantly different.




Conclusions and clinical importance –




When addressed surgically, dogs with HELP compression have similar outcomes to dogs with non-hemorrhagic IVDE.