Background: Quantitative imaging surrogates of myelin and axonal integrity using magnetization transfer and diffusion tensor imaging may provide beneficial prognostic details on long-term post-surgical recovery in dogs with spinal cord injury (SCI) secondary to intervertebral disc herniation (IVDH). Hypothesis: Magnetization transfer ratio (MTR), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and fractional anisotropy (FA) will be significantly different in patients with a successful outcome compared to patients with an unsuccessful outcome. Animals: 61 dogs with SCI secondary to IVDH were included in the final analysis. All dogs had to undergo surgical correction for SCI secondary to IVDH and be followed out for 12 weeks. Methods: Prospective cohort study. MTR, MD, AD, RD, and FA were calculated in dogs with SCI secondary to IVDH. A Wilcoxon signed-rank test was used to compare MTR, MD, AD, RD, and FA values between patients with a successful outcome and patients with an unsuccessful outcome. Statistical significance was set at p<0.05. For quantitative imaging surrogates with a significant relationship with outcome, a receiver operator characteristic (ROC) curve analysis was performed and the sensitivity and specificity for predicting successful outcome. Results: MTR (p=0.0013) was significantly lower in patients with a successful outcome compared to patients with an unsuccessful outcome. FA (p=0.435) was not significantly between groups. MD (p=0.0006), AD (p=0.0008) and RD (p=0.0002) were significantly higher in patients with a successful outcome compared to patients with an unsuccessful outcome. ROC curves were performed for MTR, AD and RD. If MTR was ≤ 53, AD ≥ 1.7 × 10-3mm2/s or RD ≥ 0.37 × 10-3 mm2/s, this resulted in a sensitivity of 96.3% and specificity of 100 in predicting a successful outcome. Conclusion and clinical relevance: MTR, MD, AD, and RD were helpful in predicting successful outcome in canine patients with surgically treated SCI secondary to IVDH. A larger cohort is needed for further evaluation. / Master of Science / Background: Certain magnetic resonance imaging (MRI) techniques can provide information about the severity of spinal cord injury. The information obtained from these MRI techniques can be helpful in predicting prognosis in dogs with intervertebral disc disease (IVDD). Hypothesis: We hypothesized that the measurements obtained from these MRI techniques would be able to predict the patients who would be able to walk following surgery (good long-term outcome), versus the patients who did not regain the ability to walk following surgery (poor long-term outcome). Animals: 62 MRIs were performed on dogs with IVDD in our study and were followed out for 12 weeks following surgery to assess long-term outcome. Results: Of the 5 MRI techniques investigated, 4 of the techniques were found to be helpful in predicted long-term outcome. When these techniques were combined, the ability to predict long-term outcome improved. Using the combined technique, all 53 patients predicted to have a good long-term had a good long-term outcome. For patients with a poor long-term outcome, 9 were predicted to have a poor long-term outcome, but only 7 patients had a poor long-term outcome. Conclusion and clinical relevance: MRI can be helpful in predicting long-term outcome in dogs with IVDD following surgery. A larger population of dogs is needed for further evaluation.

This thesis is an investigation of the access provided to the vertebral canal in dogs by the hemilaminectomy and mini-hemilaminectomy surgical techniques using computed tomography (CT), and the completeness of evacuating extruded material in dogs with intervertebral disc (IVD) extrusion using magnetic resonance imaging (MRI). Hemilaminectomy and mini-hemilaminectomy were performed on opposite sides of the spine at T11-T12, T13-L1, and L2-L3 in 10 cadavers. Measurements of the vertebral canal height, defect height, and any dorsal and ventral remnants of the vertebral arch were obtained by CT. A covariate analysis was used to compare measurements with the surgical technique, surgical site, and side of the vertebral column. Defect height was greater with hemilaminectomy due to a smaller dorsal lamina remnant. There was no statistical difference in the height of the ventral remnant, or with surgical site. Nineteen prospectively recruited dogs with suspected IVD extrusion were randomly assigned to hemilaminectomy (10 dogs) or mini-hemilaminectomy (9 dogs) groups. Intervertebral disc extrusion was identified pre-operatively with MRI and later confirmed surgically, and immediate post-operative MRI was performed at the surgical site. The volume of extruded IVD material pre- and post-operative was calculated from transverse T2 images. Although residual IVD material was present in post-operative images from all dogs in the hemilaminectomy group and only 4 in the mini-hemilaminectomy group, there was no statistically significant difference between the proportionate volumes of material removed by either technique. The median residual volume with hemilaminectomy was 13.6% (confidence interval: 7.8 – 23.6%), and with mini-hemilaminectomy was 7.7% (4.3 – 13.8%). The results of this study confirm that the difference in the defect height between techniques is related to the removal of the articular processes creating a larger defect along the dorsal vertebral canal, while no difference in access to the ventral canal was observed. No effect of vertebral site was detected suggesting neither procedure provides an advantage over the other due to location of the lesion along the thoracolumbar spine. Residual extruded IVD material occurs with both techniques; while no statistical difference was noted, a larger population should be examined. / Ontario Veterinary College Pet Trust

Temos aktualumas: 95% žmonių, kurių amžius 25–55 metai turi juosmeninės stuburo dalies tarpslankstelinę disko išvaržą L4–L5 arba L5–S1 segmentuose (Jordon et al., 2009). McKenzie tiesimo judesiai padeda daugumai pacientų, kurie skundžiasi juosmeninės stuburo dalies skausmais (Richmond, 2012). Tai saugus, nebrangus ir patikimas metodas, kuris naudojamas, kai norima išspręsti juosmeninės stuburo dalies skausmus su skausmo plitimu į koją (McKenzie, 2011). Darbo objektas: kineziterapijos ir McKenzie pratimų poveikis skausmui ir stuburo paslankumui esant juosmeninės stuburo dalies išvaržai. Tikslas: nustatyti McKenzie pratimų poveikį skausmui bei stuburo paslankumui esant juosmeninės stuburo dalies išvaržai. Uždaviniai: 1.Įvertinti ir palyginti juosmeninės stuburo dalies skausmo pokyčius taikant kineziterapiją ir McKenzie pratimus. 2.Įvertinti ir palyginti stuburo dalies paslankumą taikant kineziterapiją ir McKenzie pratimus. 3.Įvertinti ir palyginti funkcinę negalią klausimynais taikant kineziterapiją ir McKenzie pratimus. Hipotezė: manome, kad taikant McKenzie pratimus kartu su tradicine kineziterapija labiau sumažės skausmas, pagerės stuburo paslankumas juosmeninėje stuburo dalyje bei pagerės funkcinė būklė. Išvados: 1.McKenzie pratimai labiau sumažino juosmeninės stuburo dalies skausmą nei tradicinė kineziterapija. 2.McKnezie pratimai ir tradicinė kineziterapija pagerino juosmeninės stuburo dalies paslankumą. 3.McKenzie pratimai ir tradicinė kineziterapija sumažino... [toliau žr. visą tekstą] / Importance of the study: relevance of the topic: 95% of people, whos age is 25–55 years, have lumbar spine disc herniation in L4–L5 or L5–S1 segments (Jordon et al., 2009). McKenzie laying movements help for the most of the patients, who are complaining about lumbar spine part pains (Richmond, 2012). It is a safe, cheap and reliable method, which is used to solve lumbar spine part pains with pain spreading to the leg (McKenzie, 2011). Object of the research: effect of physical therapy and McKenzie exercises on pain and spine mobility in the lumbar spine hernia. The aim of the research: to determine the effect of McKenzie exercises regarding pain and mobility of spine in lumbar herniated disc. The task of the research: 1.To evaluate and compare the changes in pain of lumbar spine through physical therapy and McKenzie exercises. 2.To evaluate and compare changes in the mobility of lumbar spine through physical therapy and McKenzie exercises. 3.To evaluate and compare the functional disability after using physical therapy and McKenzie exercises. Hypothesis: the expected outcome is that physical therapy along with McKenzie exercises will reduce the pain, improve spinal mobility in the lumbar spine part and improves functional status Conclusions: 1.McKenzie exercises greater reduced the pain in lower back than conventional physical therapy. 2.McKnezie exercises and conventional physiotherapy improved the mobility of the lumbar spine. 3.McKenzie exercises and... [to full text]

Title: Physical activity of patients after surgical treatment of the lumbar spine. Aim: Main aim of the diploma thesis is to investigate which physiotherapeutic intervention for patients after spinal surgery is the most effective one and offer optimal activity immediately after the surgery and in a long term phase. Investigate questions: 1. Which physiotherapeutic intervention is the most effective one? 2. Which type of physical activity is the most optimal one? Methods: A systematic review on the topic. Results: The review answers the questions about physiotherapy after lumbar surgery in acute and long term phase after surgery and shows current trends and unique approaches in this study area. Keywords: Lumbar spine, intervertebral disc herniation, microdiscectomy, physiotherapy, physical activity.

Tyrimo objektas: pacientų funkcinės būklės kitimas, taikant skirtingas kineziterapijos programas, esant juosmeninėms disko išvaržoms. Tyrimo tikslas: nustatyti skirtingų kineziterapijos programų poveikį pacientų funkcinei būklei gydant juosmeninės stuburo dalies tarpslankstelines disko išvaržas. Tyrimo uždaviniai: 1. Nustatyti skirtingų grupių tiriamųjų tiesios kojos kėlimo kampą, ties kuriuo juntamas skausmas, pilvo ir nugaros raumenų ištvermę prieš ir po kineziterapijos. 2. Nustatyti skirtingų grupių tiriamųjų juosmeninės stuburo dalies skausmą, negalios laipsnį ir gyvenimo kokybę prieš ir po kineziterapijos. 3. Palyginti skirtingų kineziterapijos programų poveikį gydant juosmeninės stuburo dalies tarpslankstelines disko išvaržas. Tyrimas buvo atliktas 2008-2009 m. UAB „Palangos linas“ viešbutyje-reabilitacijos centre. Tyrime dalyvavo 40 tiriamųjų (19 vyrų ir 21 moteris). Sudarytos 2 grupės: I grupė (n=20) pacientai, kuriems buvo taikyta 20 IDD terapijos procedūrų. II grupė (n=20) ambulatorinės reabilitacijos pacientai. Jiems buvo taikyta 10 kineziterapijos procedūrų vertikalioje vonioje. Tiriamieji buvo vertinami prieš ir po kineziterapijos procedūrų kurso. Tyrimo metodai: Lasego mėginys, skausmo vertinimas, Oswestry negalios indeksas, nugaros raumenų ištvermės testas, pilvo raumenų ištvermės testas, SF – 36 klausimynas. Išvados: 1. Taikant tarpslankstelinę diferencinę dinaminę terapiją ir kineziterapiją vertikalioje vonioje statistiškai reikšmingai (p<0,05) padidėjo... [toliau žr. visą tekstą] / Research object: the changes patients’ functional state when applying different physiotherapy programs in cases of lumbar disc herniation. Research aim: to evaluate the influence of different physiotherapy programs on patients’ functional state after intervertebral disc herniation. Research tasks: 1. Assess the participants’ of different group’s elevation angle of straight leg, at the point of which the pain is suffered, endurance of abdominal and spinal muscles before and after physiotherapy. 2. Assess the participants’ of different group’s low back pain, degree of disability and life quality before and after physiotherapy. 3. Compare effect of different physiotherapy programs when treating lumbar intervertebral disc herniation. The research was carried out in 2008-2009 at JSC “Palangos linas” hotel – rehabilitation center. 40 (19 men and 21 women) participants took part in research. Participants were divided into 2 groups: 1st group (n=20) patients, they received 20 IDD therapy procedures. 2nd group (n=20) ambulant rehabilitation patients, they received 10 physiotherapy procedures in a vertical bath. The participants were tested before and after the physiotherapy procedures . Methods: Straight leg raise test, pain evaluation, Oswestry disability index, endurance test of spinal muscles, endurance test of abdominal muscles, SF – 36 questionnaire. Conclusions: 1. After applying intervertebral differential dynamics therapy and physiotherapy in a vertical bath, straight... [to full text]

Previous studies have reported that combination of electroacupuncture (EA) and mesenchymal stem/stromal cells (MSC) promoted survival, differentiation and functional recovery in spinal cord-transected rats. In this study, it was examined the therapeutic effects of stem cells from canine exfoliated dental pulp (SCED) combined with EA treatment in dogs with chronic naturally occurred spinal cord injury due to intervertebral disc herniation (IVDH). Dogs were randomly assigned to four experimental groups (n=4 for each group; total of 16 animals): SCED, EA, SCED + EA) and control. Mild increase in the neurological scoring was found in one animal from SCED group (1/4; 2 points gained), one from EA group (1/4; 8 points gained), three from SCED+EA group (3/4; 16 points gained) and one from control group (1/4; 2 points gained). Functional outcome improvements were observed two animals from SCED group (2/4; 3 points gained), two from EA group (2/4; 4 points gained), one from SCED+EA group (1/4; 1 point gained) and two were from control group (2/4; 6 points gained). However no statistical differences were observed. Magnetic resonance imaging (MRI) findings did not suggest improvement comparing pre- and post-treatment within groups, excepted from one animal from SCED group (1/4), and 10 animals from all groups (10/16) presented signs of injury progression in the SCI in post-treatment exam, which could not be associated to the procedures from study, but could be related to the natural evolution of the disease. Limitation such as number of transplanted stem cells, delivery route, injury chronicity and intrinsic variation among naturally spinal cord injured dogs could have influence outcomes negatively. Moreover, canine deciduous exfoliated teeth were easily obtained and SCED were simply isolated, and no mortality followed up 7 month from procedure were observed. / Estudos anteriores demonstraram que a associação da eletroacupuntura e células-tronco mesenquimais/estromais (CTMs) pode promover a sobrevivência e diferenciação das CTMs, assim como recuperação funcional em ratos com transecção da medula espinal. Neste estudo, foram avaliados os efeitos terapêuticos da associação de células-tronco derivadas de polpa de dente decíduo esfoliado de cães (CPDEc) e eletroacupuntura (EAP) em cães com lesão de medula espinhal crônica causada de forma natural por herniação do disco interververtebral. Os cães foram divididos aleatoriamente em quatro grupos experimentais (n=4 para cada grupo; total de 16 animais): CPDEc, EAP, CPDEc+EAP e grupo controle. Foram encontradas pequenas melhoras na pontuação do exame neurológico em um animal do grupo CPDEc (1/4; 2 pontos ganhos), um do grupo EAP (1/4; 8 pontos ganhos), três do grupo CPDEc+EAP (3/4; 16 pontos ganhos) e um do grupo controle (1/4; 2 pontos ganhos). Na avaliação funcional, pequenas melhoras também foram observadas em dois animais do grupo CPDEc (2/4; 3 pontos ganhos), dois do grupo EAP (2/3; 4 pontos ganhos), um do grupo CPDEc+EAP (1/4; 1 ponto ganho) e dois do grupo controle (2/4; 6 pontos ganhos). No entanto, não foram encontradas diferenças estatísticas entre os grupos. Os achados ressonância magnética não sugeriram melhoras comparando os exames pré e pós tratamento entre os grupos, com exceção de um animal do grupo CPDEc (1/4), e 10 animais dentre todos os grupos (10/16) apresentaram sinais de progressão na lesão da medula espinhal, que não puderam ser associados com os procedimentos do estudo, mas podem estar relacionados à progressão natural da doença. Além disso, os dentes decíduos esfoliados foram obtidos facilmente e as CPDEc foram isoladas de forma simples, ademais, não foi observada nenhuma mortalidade foi observada até 7 meses após o procedimento.

Previous studies have reported that combination of electroacupuncture (EA) and mesenchymal stem/stromal cells (MSC) promoted survival, differentiation and functional recovery in spinal cord-transected rats. In this study, it was examined the therapeutic effects of stem cells from canine exfoliated dental pulp (SCED) combined with EA treatment in dogs with chronic naturally occurred spinal cord injury due to intervertebral disc herniation (IVDH). Dogs were randomly assigned to four experimental groups (n=4 for each group; total of 16 animals): SCED, EA, SCED + EA) and control. Mild increase in the neurological scoring was found in one animal from SCED group (1/4; 2 points gained), one from EA group (1/4; 8 points gained), three from SCED+EA group (3/4; 16 points gained) and one from control group (1/4; 2 points gained). Functional outcome improvements were observed two animals from SCED group (2/4; 3 points gained), two from EA group (2/4; 4 points gained), one from SCED+EA group (1/4; 1 point gained) and two were from control group (2/4; 6 points gained). However no statistical differences were observed. Magnetic resonance imaging (MRI) findings did not suggest improvement comparing pre- and post-treatment within groups, excepted from one animal from SCED group (1/4), and 10 animals from all groups (10/16) presented signs of injury progression in the SCI in post-treatment exam, which could not be associated to the procedures from study, but could be related to the natural evolution of the disease. Limitation such as number of transplanted stem cells, delivery route, injury chronicity and intrinsic variation among naturally spinal cord injured dogs could have influence outcomes negatively. Moreover, canine deciduous exfoliated teeth were easily obtained and SCED were simply isolated, and no mortality followed up 7 month from procedure were observed. / Estudos anteriores demonstraram que a associação da eletroacupuntura e células-tronco mesenquimais/estromais (CTMs) pode promover a sobrevivência e diferenciação das CTMs, assim como recuperação funcional em ratos com transecção da medula espinal. Neste estudo, foram avaliados os efeitos terapêuticos da associação de células-tronco derivadas de polpa de dente decíduo esfoliado de cães (CPDEc) e eletroacupuntura (EAP) em cães com lesão de medula espinhal crônica causada de forma natural por herniação do disco interververtebral. Os cães foram divididos aleatoriamente em quatro grupos experimentais (n=4 para cada grupo; total de 16 animais): CPDEc, EAP, CPDEc+EAP e grupo controle. Foram encontradas pequenas melhoras na pontuação do exame neurológico em um animal do grupo CPDEc (1/4; 2 pontos ganhos), um do grupo EAP (1/4; 8 pontos ganhos), três do grupo CPDEc+EAP (3/4; 16 pontos ganhos) e um do grupo controle (1/4; 2 pontos ganhos). Na avaliação funcional, pequenas melhoras também foram observadas em dois animais do grupo CPDEc (2/4; 3 pontos ganhos), dois do grupo EAP (2/3; 4 pontos ganhos), um do grupo CPDEc+EAP (1/4; 1 ponto ganho) e dois do grupo controle (2/4; 6 pontos ganhos). No entanto, não foram encontradas diferenças estatísticas entre os grupos. Os achados ressonância magnética não sugeriram melhoras comparando os exames pré e pós tratamento entre os grupos, com exceção de um animal do grupo CPDEc (1/4), e 10 animais dentre todos os grupos (10/16) apresentaram sinais de progressão na lesão da medula espinhal, que não puderam ser associados com os procedimentos do estudo, mas podem estar relacionados à progressão natural da doença. Além disso, os dentes decíduos esfoliados foram obtidos facilmente e as CPDEc foram isoladas de forma simples, ademais, não foi observada nenhuma mortalidade foi observada até 7 meses após o procedimento.