Association between anesthesia duration and outcome in dogs with surgically treated acute severe spinal cord injury caused by thoracolumbar intervertebral disk herniation

Abstract

Background: Retrospective research recently identified a possible relationship between duration of surgery and outcome in severely affected dogs treated surgically for acute thoracolumbar intervertebral disk herniation (TL-IVDH).

Hypothesis: That increased duration of surgery is associated with poorer outcome in dogs with absent pain perception treated surgically for TL-IVDH.

Animals: Two hundred ninety-seven paraplegic dogs with absent pain perception surgically treated for acute TL-IVDH.

Methods: Retrospective cohort study. Medical records of 5 institutions were reviewed. Inclusion criteria were paraplegia with absence of pain perception, surgical treatment of TL-IVDH, and 1-year postoperative outcome (ambulatory: yes or no). Canine data, outcome, and surgery and total anesthesia duration were retrieved.

Results: In this study, 183/297 (61.6%) dogs were ambulatory within 1 year, 114 (38.4%) dogs failed to recover, including 74 dogs (24.9%) euthanized because of progressive myelomalacia. Median anesthesia duration in dogs that regained ambulation within 1 year of surgery (4.0 hours, interquartile range [IQR] 3.2-5.1) was significantly shorter than those that did not (4.5 hours, IQR 3.7-5.6, P = .01). Multivariable logistic regression demonstrated a significant negative association between both duration of surgery and total anesthesia time and ambulation at 1 year when controlling for body weight and number of disk spaces operated on.

Conclusions and clinical importance: Findings support a negative association between increased duration of anesthesia and outcome in this group of dogs. However, the retrospective nature of the data does not imply a causal relationship.

Keywords: canine; extrusion; hemilaminectomy; prognosis; surgery.

FIGURE 1

Dot plots showing the distribution of total anesthesia duration (Total general anesthesia (GA) duration) for 297 dogs with absent pain perception that were ambulatory (n = 183) or nonambulatory (n = 114) within 1 year of underdoing surgical treatment for acute thoracolumbar intervertebral disk herniation. Central line = median, whiskers = interquartile range. *Statistically significant difference (P = .010)

FIGURE 2

Dot plots showing the distribution of surgery duration for 297 dogs with absent pain perception that were ambulatory (n = 183) or nonambulatory (n = 114) within 1 year of underdoing surgical treatment for acute thoracolumbar intervertebral disk herniation. Central line = median, whiskers = interquartile range. The difference in surgery duration between outcome groups was not statistically significant (P = .057)