ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion
Olby, N.J. et al. (2022) ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion. Journal of Veterinary Internal Medicine, 36 (5), pp. 1570-1596.
The aim of this consensus statement was to review the available literature on the diagnosis and management of acute thoracolumbar intervertebral disc extrusion (TL-IVDE) in dogs and to make recommendations based on the consensus of the expert panel.
The panel consisted of eight experts in the field. Using the standard methodology for ACVIM consensus statements, they assessed and summarised the evidence and agreed on consensus clinical recommendations using a modified Delphi method. The body of evidence supporting each recommendation was graded low, medium or high level.
The evidence review and recommendations are presented under the following headings: diagnostic approaches, medical management (including exercise restriction and rehabilitation), surgical approaches, neuroprotective strategies, pain management and management of urination.
Findings from the evidence review showed that most recommendations made by the panel were supported by low or moderate levels of evidence, with the majority of available evidence from observational studies. Areas where the need for further study was highlighted included ideal timing for surgical decompression, expected surgical vs medical outcomes for mildly affected cases, the impact of durotomy on outcome and development of progressive myelomalacia, and refining of postoperative and preventative care.
This consensus statement provides practitioners with an overview of the current knowledge of, and evidence-based recommendations on, the diagnosis and management of acute thoracolumbar intervertebral disc extrusion in dogs. It will provide useful information for the management of individual cases as well as a starting point on which to develop local practice guidelines.
The following may also be of interest:
Smith, C. (2021) Evaluating the reliability of computed tomography for the diagnosis of intervertebral disc extrusion in dogs. Veterinary Evidence, 6 (4). https://doi.org/10.18849/ve.v6i4.384
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