Associations between cerebrospinal fluid biomarkers and long-term neurologic outcome in dogs with acute intervertebral disk herniation

作者：Wit**erger Tige H^*; Levine Jonathan M; Fosgate Geoffrey T; Slater Margaret R; Kerwin Sharon C; Russell Karen E; Levine Gwendolyn J

来源：Journal of the American Veterinary Medical Association, 2012, 240(5): 555-562.

DOI：10.2460/javma.240.5.555

Objective-To examine associations between CSF biomarkers, initial neurologic dysfunction, and long-term ambulatory outcome in dogs with acute intervertebral disk herniation (IVDH). %26lt;br%26gt;Design-Prospective clinical study. %26lt;br%26gt;Animals-54 dogs with acute thoracolumbar IVDH and 16 clinically normal dogs. %26lt;br%26gt;Procedures-For each dog, variables, including CSF myelin basic protein (MBP), lactate, calcium, glucose, and total protein concentrations; nucleated cell count; and creatine kinase (CK) and aspartate aminotransferase activities, were measured. For dogs with thoracolumbar IVDH, initial neurologic function was characterized by use of a modified Frankel score (MFS; determined on a scale of 0 to 5, where 0 represented paraplegia with no deep nociception and 5 represented paraspinal hyperesthesia only). Long-term follow-up was assessed. %26lt;br%26gt;Results-Among dogs with thoracolumbar IVDH, those with CSF CK activity %26lt;= 38 U/L had a 35-fold increase in the odds of long-term ambulation, compared with the odds in dogs with CSF CK activity %26gt; 38 U/L, adjusting for neurologic functioning at the evaluation. The CSF lactate, calcium, and glucose concentrations and aspartate aminotransferase activity were not predictive of long-term ambulatory outcome. Data analysis revealed that long-term functional recovery was %26gt; 98% for affected dogs, regardless of their initial MFS, when CSF CK activity was %26lt;= 38 U/L and M B P concentration was %26lt;= 3 ng/mL. Conclusions and Clinical Relevance-In dogs with acute thoracolumbar IVDH, CSF CK activity and MBP concentration appeared to be prognostic indicators and, along with initial MFS, can be used to predict long-term ambulatory outcome. (J Am Vet Med Assoc 2012;240:555-562)

• 出版日期2012-3-1