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  • Title: Comparison of surgical and conservative treatment of hydrated nucleus pulposus extrusion in dogs.
    Author: Nessler J, Flieshardt C, Tünsmeyer J, Dening R, Tipold A.
    Journal: J Vet Intern Med; 2018 Nov; 32(6):1989-1995. PubMed ID: 30267615.
    Abstract:
    BACKGROUND: Whether compressive cervical myelopathy caused by hydrated nucleus pulposus extrusion (HNPE) in dogs should be treated surgically or conservatively has been debated. Only 1 recent study has contradicted the former predominant reports of surgical treatment for HNPE. HYPOTHESIS AND METHOD: Single center retrospective study to compare the outcome of client-owned dogs with HNPE after decompressive surgery or conservative treatment. ANIMALS: Thirty-six dogs diagnosed with HNPE confirmed by magnetic resonance imaging (MRI). RESULTS: Eighteen of 36 dogs underwent surgery whereas 18 dogs were managed conservatively including cage rest and physiotherapy. The most common affected intervertebral disc space was C4-5. In 3 dogs, HNPE was diagnosed at the level of T13-L1. Median time to regain ambulation was 6.6 days (range, 0-28 days) after surgery and 5.9 days (range, 0-15 days) with conservative management (P = .37). Only the length of a potential intramedullary lesion in cervical HNPE detected by MRI had an influence on the prognosis to gain ambulatory status in a time period of ≤9 days (P = .0035) and on short-term survival (P = .0011). CONCLUSIONS AND CLINICAL IMPORTANCE: Conservative management of HNPE in the cervical as well as in the thoracolumbar region represents a reasonable alternative to surgery, showing similar favorable outcome.
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