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  4. Emerging and Adjunctive Therapies for Spinal Cord Injury Following Acute Canine Intervertebral Disc Herniation

Emerging and Adjunctive Therapies for Spinal Cord Injury Following Acute Canine Intervertebral Disc Herniation

Frontiers in Veterinary Science, 2020 · DOI: 10.3389/fvets.2020.579933 · Published: October 15, 2020

Spinal Cord InjuryNeurologyVeterinary Medicine

Simple Explanation

Some dogs don't fully recover after surgery or medication for a slipped disc. This shows current treatments have limits. There's lots of research into new ways to help dogs with spinal cord injuries. These strategies aim to fix the spinal cord, help nerves regrow, protect against further damage, or improve how the dog functions. Many promising treatments have failed in trials with humans and dogs. It's still important to find new treatments for dogs. This helps us learn how injuries heal and create better treatment plans. This article reviews new and upcoming treatments for dogs with slipped discs. This review outlines treatments for dogs with slipped discs, including treatments focused on the injury area and systemic treatments in acute and subacute-to-chronic settings. These interventions include low-level laser therapy, electromagnetic fields, adjunctive surgical techniques, systemically or locally-applied hypothermia, neuroprotective chemicals, physical rehabilitation, hyperbaric oxygen therapy, electroacupuncture, electrical stimulation, nerve grafting strategies, and cell transplantation.

Study Duration
Not specified
Participants
Companion dogs with naturally-occurring SCI and experimental dogs
Evidence Level
Review article

Key Findings

  • 1
    Low-level laser therapy may reduce time to ambulation after surgery, but evidence is mixed and studies are limited.
  • 2
    Pulsed electromagnetic field therapy may reduce post-operative pain and improve neurologic benefit in dogs with IVDH, but sample sizes are small.
  • 3
    Durotomy may be beneficial in dogs with severe injury, especially in preventing development of progressive myelomalacia.

Research Summary

This review summarizes emerging and adjunctive therapies for spinal cord injury (SCI) following acute canine intervertebral disc herniation (IVDH). It discusses local or lesion-based approaches as well as systemically applied treatments in both acute and subacute-to-chronic settings. The review covers interventions such as laser therapy, electromagnetic fields, adjunctive surgical techniques (myelotomy or durotomy), hypothermia, neuroprotective chemicals, physical rehabilitation, hyperbaric oxygen therapy, electroacupuncture, electrical stimulation, nerve grafting strategies, 4-aminopyridine, chondroitinase ABC, and cell transplantation. The authors conclude that multimodal approaches to therapy building on conventional treatment options will likely be most successful in treating severe SCI.

Practical Implications

Clinical Practice

Veterinarians can consider adjunctive therapies alongside conventional treatments for canine IVDH, such as laser therapy, PEMF, or durotomy, based on the available evidence and individual patient needs.

Research

Further research is needed to optimize treatment protocols and validate objective outcome measures for physical rehabilitation in dogs recovering from IVDH.

Future Directions

Multimodal approaches to therapy, combining various techniques, may hold the greatest promise for improving outcomes in dogs with severe SCI.

Study Limitations

  • 1
    High quality evidence is lacking for many interventions.
  • 2
    Many studies included a relatively small number of dogs in each treatment group.
  • 3
    Heterogeneity of clinical lesions and the need to increase case numbers to better assess the efficacy of cell transplant techniques.

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