Prognostic indicators for time to ambulation after surgical decompression in nonambulatory dogs with acute thoracolumbar disk extrusions: 112 cases

Objectives-To determine prognostic indicators for time to ambulation after surgical decompression in nonambulatory dogs with intact pain sensation and acute Hansen type-1 disk extrusions. Study Design-Retrospective clinical study. Animals-One-hundred twelve dogs with Hansen type-l disk extrusions that had decompressive hemilaminectomy or dorsal laminectomy. Methods-All dogs had thoracolumbar disk extrusion and were nonambulatory with intact pain sensation at admission. Variables considered included age, weight, voluntary motor function at time of anesthetic induction, glucocorticoid use, times from onset of nonambulatory status to admission and surgical decompression, time in hospital to surgical decompression, anesthetic time, surgical time, number of contrast injections required to perform a diagnostic myelogram, postoperative pain sensation, and postoperative voluntary motor function. Time to ambulation was defined as the number of days from surgical decompression until the dog was able to stand and take a series of steps without assistance. Results-One-hundred seven dogs (96%) were able to ambulate within 3 months. The mean time to ambulation was 12.9 days and was significantly shorter if dogs had postoperative voluntary motor function (7.9 days v 16.4 days, P < .0001). No other variable had a significant association with time to ambulation. Conclusions-Few perioperative variables have prognostic value for return to ambulation. Nonambulatory dogs with intact pain sensation and Hansen type-l disk extrusions in the thoracolumbar spine that are treated with surgical decompression have a favorable prognosis. Clinical Relevance-The presence of postoperative voluntary motor function is a favorable prognostic indicator for early return to ambulation. (C) Copyright 2002 by The American College of Veterinary Surgeons.