最新狗腰間盤突出

1、Degenerative Disc Disease in Dogs狗錐間盤突出Degenerative Disc Disease in DogsPet IWhat is a disc, and what is its purpose?椎間盤及其功能The spinal cord脊髓 is one of the most important and sensitive organ systems in the body. If it is damaged, the nerve cells do not regenerate but are replaced with fibrous or sca

2、r tissue. Spinal cord injuries usually result in permanent, irreversible damage. To protect it from damage, the spinal cord runs through a bony canal within the spine and is surrounded by protective bone everywhere except the junction of the vertebrae. These junctions are filled by rubber-like cushi

3、ons called intervertebral discs.椎間盤 The individual vertebrae and intervertebral discs allow the back to move up and down and sideways without allowing contact between the bones of the spinal column. 脊柱This extreme protection of the spinal cord reflects its importance and fragility.脊髓是動(dòng)物體內(nèi)最重要、最敏感的器官系

4、統(tǒng)之一，一旦損壞，腦神經(jīng)細(xì)胞將不能修復(fù)再生，從而變?yōu)槔w維和疤痕組織。脊髓損傷通常是永久不可逆的。為保護(hù)脊髓免受損傷，脊髓在椎管內(nèi)向后延伸（由所有的椎骨按前后順序連接一起形成的一個(gè)連續(xù)的管道），通過椎間孔進(jìn)出椎管。椎骨通過類似橡膠墊的具有彈性的椎間盤來連接。通過這種結(jié)構(gòu)，單個(gè)椎骨和椎間盤讓背上下左右活動(dòng)而避免了椎骨之間接觸。這種保護(hù)脊髓的方式使得脆弱的椎間盤具有重要的作用。What does it mean for a disc to rupture, and how does it happen?椎間盤突出及其發(fā)生The disc is composed of two parts. 椎間盤是由

5、兩部分組成。The disc is composed of two parts. The outer covering (fibrous ring) is much like a thick shell. It is comprised of tough fibers that protect and contain the central part (pulpy nucleus). The disc is thinnest at the top. This thin area is located just below the spinal cord脊髓. The central part

6、of the disc is much softer than the outer part and has the consistency of thick toothpaste. 椎間盤是由兩部分構(gòu)成。外層(纖維環(huán))是一個(gè)厚的殼，它是由堅(jiān)硬的纖維構(gòu)成，保護(hù)并包含中央部分髓核 。髓核部分最薄，位于脊髓正下方，比外層柔軟并富有彈性。Degenerative disc disease causes spontaneous degeneration of the outer part of the disc, resulting in sudden disc rupture or herniati

7、on (also called a slipped disc). It may not be related to injury, although the rupture frequently occurs after some sort of traumatic event, such as a fall or a relatively small jump. Although this act is frequently blamed for the disc rupture, the injury actually occurred due to chronic disc degene

8、ration. Most dogs with degenerative disc disease are middle-aged, from three to seven years old. There is likely a genetic predisposition to this disease. Certain breeds, especially the Dachshund, Poodle, Pekinese, Lhasa Apso, German shepherd, Doberman and Cocker Spaniel have a high incidence of int

9、ervertebral disc disease. 椎間盤變性性疾病導(dǎo)致自發(fā)退變的椎間盤，導(dǎo)致突然椎間盤破裂或突出癥 (也稱為椎間盤突出) 。它可能與受傷無關(guān)，雖然在某種外部創(chuàng)傷后，如跌倒或小幅度跳躍后會(huì)經(jīng)常發(fā)生。這經(jīng)常被認(rèn)為是椎間盤破裂，實(shí)際上損傷的發(fā)生是由于慢性椎間盤退變。大多數(shù)狗發(fā)生椎間盤退行性疾病在中年（三至七歲）?？赡苁沁@種疾病的遺傳易感性，有些品種，尤其是臘腸犬、 貴賓犬、 獅子狗、 拉薩犬、 德國牧羊犬、 杜賓犬和可卡犬發(fā)病率高。Because the spinal cord is encased within its bony canal, it cannot move awa

10、y from the pressure and it becomes pinched.因?yàn)榧顾韫潭ㄔ谧倒軆?nèi)，不可避免的受到脫出的椎間盤的擠壓When the outer shell degenerates, it allows the central part of the disc to escape. Since the disc is thinnest near the spinal cord, disc material that escapes through the tear usually goes upward, putting pressure on the spinal c

11、ord. Because the spinal cord is encased within its bony canal, it cannot move away from the pressure and it becomes pinched.當(dāng)纖維環(huán)變性后，中央的髓核從裂縫脫出。髓核柔軟富有彈性，可凸入脊髓并產(chǎn)生壓迫，因?yàn)榧顾韫潭ㄔ谧倒軆?nèi)，不能避開破損的椎間盤，從而受到“擠壓”。How does a slipped disc affect the spinal cord?突出的椎間盤如何影響脊髓？The spinal cord is like a telephone cable carr

12、ying thousands of tiny wires. When it is crushed, transmission of information through the wires is slowed or stopped. When the disc degenerates and ruptures, it crushes the spinal cord and the nerves that leave the spinal cord over the discs (i.e. spinal nerves). Pressure on the spinal nerves result

13、s in pain. Pressure on the spinal cord results in pain and/or loss of information transmission, causing partial or complete paralysis. 脊髓是像電話線包裹許多微細(xì)的光纜。當(dāng)它被擠壓損傷時(shí)，信號(hào)通過神經(jīng)傳遞的速度會(huì)減慢甚至停止。當(dāng)椎間盤脫出，會(huì)擠壓進(jìn)出脊髓的神經(jīng) (即脊神經(jīng))。脊髓神經(jīng)受壓力導(dǎo)致疼痛。壓迫脊髓導(dǎo)致疼痛或信號(hào)損失，導(dǎo)致局部或全身癱瘓。Most disc ruptures occur in the middle to lower part of the

14、 back. However, they may also occur in the neck. Back injuries often cause paralysis without severe pain while neck injuries usually cause severe pain without paralysis. If paralysis affects all four legs, the disc rupture must be in the neck. Due to the way nerve tracts are arranged in the spinal c

15、ord, disc ruptures in the neck may affect the rear legs first and may not involve the front limbs. 大多數(shù)的椎間盤破裂發(fā)生在背的中后部，但是也可能發(fā)生在頸部。背部椎間盤損傷經(jīng)常導(dǎo)致癱瘓不會(huì)伴劇烈疼痛，頸部損傷通常會(huì)劇烈疼痛但不會(huì)癱瘓。如果癱瘓后四肢都受到影響，椎間盤損傷必然發(fā)生在頸部。由于神經(jīng)在脊髓上的走行，頸部椎間盤破裂可能首先影響后肢不影響前肢。（這一段翻譯的可能有大問題）How fast do intervertebral discs degenerate and rupture?椎間盤發(fā)生

16、退行性變和突出需要多久？Disc degeneration occurs relatively slowly, and a rupture may occur slowly and gradually, so that degenerated disc material slowly escapes from the disc over several days or weeks. In these cases, the dog often experiences pain and is reluctant to move. It may lie around for a few days a

17、llowing the body to try to heal the injury, often without the owner being aware that a problem existed. 椎間盤退變發(fā)生相對(duì)較慢，破裂逐漸出現(xiàn)，以致在幾天或幾周時(shí)間內(nèi)退變的髓核慢慢從椎間盤滑出。這時(shí)你的狗會(huì)經(jīng)常疼痛并不愿活動(dòng)。它可能是想嘗試休息幾天時(shí)間讓身體的損傷恢復(fù)，往往沒有意識(shí)到問題的存在。Some dogs will go from normal walking to total paralysis in less than one hour. 有些看起來正常的狗狗會(huì)在短短一個(gè)小時(shí)之內(nèi)忽

18、然全身癱瘓。However, discs may also rupture very acutely. Some dogs will go from normal walking to total paralysis in less than one hour. 然而，椎間盤退變發(fā)生可能也很劇烈。有些看起來正常的狗狗會(huì)在短短一個(gè)小時(shí)之內(nèi)忽然全身癱瘓。How is a slipped disc diagnosed?椎間盤突出如何診斷？A presumptive diagnosis of disc disease will be based on the dogs history of neck

19、or back pain, uncoordinated walking, or paralysis, with or without a history of recent trauma. If the dog is one of the high incidence breeds, this disease will be high on the list of potential causes of the patients symptoms. 初步診斷時(shí)椎間要了解狗狗在近期的外傷后有沒有頸部或背部疼痛、 行走不協(xié)調(diào)協(xié)調(diào)或者癱瘓的癥狀。如果狗狗是發(fā)病率高的品種之一，在這些癥狀下，狗狗患腰間

20、盤突出的可能性會(huì)很高。.a myelogram may be performed.X光片診斷In some cases, plain radiographs (x-rays) may assist the diagnosis. However, plain radiographs may show no abnormalities, since neither the disc nor the spinal cord is readily visible on an x-ray. If the diagnosis is in doubt or if the patient will under

21、go surgery, a myelogram may be performed. This procedure involves injecting a special dye around the spinal cord of the anesthetized dog and then taking a series of radiographs. The dye will outline the spinal cord. A break in the dye column means that there is pressure on the spinal cord at that po

22、int. If available, computed tomography (CT) scans and magnetic resonance imaging (MRI) may be used to diagnose intervertebral disc herniation. 在某些情況下，光片 (x 射線) 可協(xié)助診斷。然而，光片可能會(huì)顯示無異常，因?yàn)樽甸g盤和脊髓都不都在 x 線下觀察。如果對(duì)診斷有疑問，可以通過手術(shù)觀察。此過程需要向麻醉后犬的脊髓周圍注射特殊染料，然后采取多次的射線成像。染料可將脊髓的輪廓在x射線下顯示。染料輪廓破損的部位就表明著脊髓在那一點(diǎn)受到壓迫。如果可以用計(jì)算

23、機(jī)斷層掃描 (CT) 和磁共振成像 (MRI) 可用于診斷椎間盤突出癥。How do you know if the pressure on the spinal cord is due to a disc or something else?如何判斷脊髓壓迫是椎間盤突出引起的？It is possible that the pressure is due to a blood clot or tumor. Both are possible but rare, especially when compared to disc ruptures. If the patient is a hig

24、h-risk breed and there has been a sudden onset of paralysis without severe trauma, there is an approximately 95% chance that a disc rupture is causing the clinical signs. However, the diagnosis is not definite until the time of surgery壓迫也可能是由于血液阻塞或腫瘤，但是與椎間盤突出相比可能性極小。如果狗狗是該病的高發(fā)品種并且有過在未受嚴(yán)重創(chuàng)傷的情況下突發(fā)麻痹，那

25、么95%的可能是椎間盤破裂導(dǎo)致的臨床癥狀。然而，在手術(shù)之前并不能確診。Are all disc ruptures treated with surgery?所有的椎間盤突出都必須手術(shù)進(jìn)行治療嗎？Not necessarily. The recommended treatment is based on the stage of the disease: 不是必須的，我們建議治療方法要依據(jù)椎間盤突出發(fā)生的程度 : Stage I disc disease produces mild pain and is usually self-correcting in a few days. Stage

26、II disc disease causes moderate to severe pain in the neck or lumbar (lower back) area. Stage III disc disease causes partial paralysis (paresis) and results in the dog walking in staggering or uncoordinated movements. Stage IV disc disease causes paralysis but the ability to feel is present. Stage

27、V disc disease causes paralysis and loss of feeling. 第一階段 產(chǎn)生中度疼痛，通常在幾天內(nèi)自愈。 第二階段 導(dǎo)致頸腰部（背部）中度至重度疼痛。 第三階段 導(dǎo)致局部麻痹 (麻痹)，遛狗時(shí)會(huì)發(fā)現(xiàn)狗狗運(yùn)動(dòng)不協(xié)調(diào)或者行走不穩(wěn)。 第四階段 造成癱瘓但有知覺。 第五階段 造成癱瘓并喪失知覺。These stages tend to overlap in some dogs, and dogs may move from one stage to another over a period of hours to days. Dogs with Stage

28、 II and III disease are usually treated with anti-inflammatory drugs, pain relievers, and exercise restriction. If the pain or lack of coordinated movements persists after four to seven days of treatment or if the neurological status declines from one day to the next, surgery may be required. The ti

29、me of confinement will vary based on each patients condition. 這些階段往往是不同程度同時(shí)疊加的，狗狗可能會(huì)從一個(gè)階段進(jìn)入到另一個(gè)階段只要幾個(gè)小時(shí)或幾天天。第二階段和第三階段的患病狗狗通常用消炎藥，止痛藥治療，并限制狗狗的活動(dòng)。如果疼痛或運(yùn)動(dòng)不協(xié)調(diào)的癥狀在治療47天后仍然不減，或神經(jīng)系統(tǒng)的狀態(tài)從一天天下降，就可能需要手術(shù)。具體發(fā)生時(shí)間會(huì)因每只狗狗的病情而異。Dogs with Stage IV disease should have surgery, although a small percentage will recover w

30、ithout it. Dogs with Stage V disease should have surgery immediately. The sooner that surgery is done, the better the prognosis. Ideally, these dogs should be operated on within the first 24 hours of the onset of paralysis. 第四階段的疾病犬應(yīng)該采取手術(shù)，即使仍有恢復(fù)的機(jī)率（不動(dòng)手術(shù)）。第五階段疾病的犬應(yīng)該立即做手術(shù)，越早越好，最理想的是在發(fā)病的 24 小時(shí)內(nèi)做手術(shù)。What

31、 is the purpose of surgery? 手術(shù)目的是什么？The goal of surgery is to remove pressure from the spinal cord. 手術(shù)目的是解除脊髓壓迫。The goal of surgery is to remove pressure from the spinal cord. If the disc rupture occurs in the lower back, a window (called a fenestration) is made in the side of the vertebral bone to

32、expose the spinal cord. This window allows removal of disc material and relieves pressure from the cord. If the disc rupture occurs in the neck, a window is made in the bone exposing the spinal cord. This may be done from either the top or the bottom, depending on the situation and the veterinarians

33、 preference. 手術(shù)目的是解除脊髓壓迫。如果椎間盤突出發(fā)生在背后半部，一個(gè)開口(稱為開窗) 進(jìn)行椎體骨側(cè)暴露脊髓。通過窗口將突出的髓核去除，減輕脊髓受壓。如果椎間盤突出發(fā)生在頸部，開窗口暴露脊髓骨可以從頂部或底部，可根據(jù)情況和獸醫(yī)的偏好選定。What is the success rate for treating disc disease with and without surgery? 手術(shù)治療和不經(jīng)手術(shù)治療痊愈的機(jī)率Stage Recovery without Surgery Recovery with Surgery I: up to 1 week 80-90% 90-95

34、% II: past 1 week 60-70% 90-95% III 30-40% 85-95% IV: up to 3 days 25% 85-95% IV: past 3 days 20% 60-70% V: up to 24 hours 5% 50% V: past 24 hours 5% 20% 階段無需手術(shù)的恢復(fù)手術(shù)恢復(fù)I: 一周內(nèi)80-90%90-95%II: 一周后60-70%90-95%III 30-40%85-95%IV: 三天內(nèi) 25%85-95%IV: 三天后 20%60-70%V: 24h內(nèi) 5%50%V: 24h后 5% 20%When will we know i

35、f the surgery is successful?何時(shí)判斷手術(shù)是否成功？Unfortunately, success cannot be determined immediately. The return of neurological function, walking ability and relief from pain may not occur for several days to weeks after surgery.很遺憾，手術(shù)是否成功并不能很快判斷，神經(jīng)元的恢復(fù)、行走能力以及疼痛的的減輕都不能在手術(shù)后短短幾天或幾個(gè)星期之內(nèi)見效。When can my dog go

36、 home?我們的狗手術(shù)后多久能出院回家？Following surgery, your dog will be hospitalized for several days. Bladder and bowel control are often lost when the dog is paralyzed. It is better for your dog to remain hospitalized until control of these functions has returned. It is generally better not to extend hospitaliza

37、tion beyond seven days because regaining the ability to walk partly depends on exercise and motivation. Since motivation is such an important part of the recovery process, we encourage you to visit your dog starting a few days after surgery.經(jīng)過手術(shù)，你的狗狗將住院幾天。當(dāng)狗狗癱瘓，消化和泌尿系統(tǒng)功能較低。最好讓你的狗繼續(xù)住院，直到身體各項(xiàng)機(jī)能恢復(fù)。不過通常

38、延長住院時(shí)間不要超過七天，因?yàn)榛謴?fù)行走能力一部分取決于運(yùn)動(dòng)和恢復(fù)動(dòng)力。因?yàn)閯?dòng)力是重要的恢復(fù)過程，我們鼓勵(lì)您手術(shù)后多去醫(yī)院看望您的狗。 Recovery is dependent on four factors: whether permanent damage was done before surgery, if the surgery relieved the pressure quickly enough, if physical therapy can be performed at home, and if the dog is motivated to recover. 恢復(fù)取決于

39、四個(gè)因素: 手術(shù)是否永久性損傷，手術(shù)減輕一些壓力不夠快，如果可以在家里進(jìn)行物理治療，如果這只狗是動(dòng)機(jī)來恢復(fù).If paralysis was present before surgery, your dog may not be able to walk when it is discharged from the hospital. You will be given detailed instructions on the procedures that should be performed. Recovery is dependent on four factors: whether

40、permanent damage was done before surgery, if the surgery relieved the pressure quickly enough, if physical therapy can be performed at home, and if the dog is motivated to recover.如果手術(shù)前就已經(jīng)癱瘓，你的狗可能不能走路時(shí)它出院。你會(huì)應(yīng)執(zhí)行的程序給予詳細(xì)的說明?；謴?fù)是取決于四個(gè)因素: 是否永久性損傷過手術(shù)，如果手術(shù)減輕一些壓力不夠快，如果可以在家里進(jìn)行物理治療，如果這只狗是動(dòng)機(jī)來恢復(fù)。Can my dog slip

41、a disc again?我家狗手術(shù)后會(huì)不會(huì)復(fù)發(fā)？The answer is yes. However, as discussed above, not all disc herniations require surgery. 答案是肯定。然而，如上文所討論，并不是所有的椎間盤突出都需要手術(shù)。What if the myelogram is normal?如果脊髓造影顯示正常怎么辦？The purpose of the myelogram is to identify pressure on the spinal cord. If the myelogram is normal, there

42、 is no pressure on the spinal cord. This has several important implications. First, it means that surgery will generally not be appropriate. Seond, it means that one of the following conditions is likely to exist: 脊髓造影的目的是確診脊髓壓迫，如果脊髓造影顯示正常，沒有壓迫神經(jīng)，那就會(huì)有以下幾種可能。1.一般不需要手術(shù)來治療；2.它可能存在以下問題:Spinal Shock. Thi

43、s is a temporary loss of spinal function that is generally associated with trauma. It occurs suddenly and is somewhat like a concussion of the brain. It may leave permanent damage or full recovery may occur. Recovery from spinal shock generally occurs within a few hours to a few days. 脊髓休克。這是創(chuàng)傷導(dǎo)致的脊髓

44、功能暫時(shí)喪失。它通常會(huì)突然發(fā)生，某種程度上類似于腦震蕩。它可能造成永久性損傷也可能完全恢復(fù)。從脊髓休克的復(fù)蘇通常會(huì)發(fā)生在幾個(gè)小時(shí)內(nèi)，或幾天內(nèi)。Fibrocartilaginous Embolism. In this condition, a small amount of disc material ruptures and gets into one of the blood vessels leading to the spinal cord. As the vessel narrows, the disc material obstructs it, depriving a certai

45、n segment of the spinal cord of its blood supply. Without proper blood supply, that segment of the spinal cord dies, resulting in paralysis. Surgery will not help these dogs because there is no pressure on the spinal cord. Often, paralysis involves only one rear leg, or one rear leg is more severely

46、 affected than the other is. Complete recovery may occur in a few days to weeks, or there may be permanent damage to a portion of the spinal cord. Diagnosis of fibrocartilaginous embolism is based on the correct clinical signs and a normal myelogram. Unfortunately, a definitive diagnosis can only be

47、 made by performing a spinal cord biopsy after death. 纖維軟骨栓塞。在這種情況下，極少量的椎間盤內(nèi)容物破裂并進(jìn)入血管導(dǎo)致脊髓損傷。血管微細(xì)被椎間盤內(nèi)容物阻塞，從而導(dǎo)致某些部位血液運(yùn)輸受到影響，這些部位的脊髓得不到血液的供應(yīng)而死亡，導(dǎo)致癱瘓。這時(shí)候手術(shù)不能幫助小狗，因?yàn)檫@不是椎間盤脫出導(dǎo)致的脊髓壓迫。通常情況下，只會(huì)癱瘓一只后肢或一只后肢比其他條腿嚴(yán)重。完全恢復(fù)可能會(huì)需要幾天到幾周的時(shí)間，也可能脊髓的某些部位被永久損害。纖維軟骨栓塞的診斷要根據(jù)臨床癥狀并確定脊髓造影顯示正常。不幸的是，確診只能死后通過解剖觀察。Degenerative Mye

48、lopathy. This is a condition where the spinal cord is slowly dying. It results in progressive paralysis that begins with the dog dragging its rear feet as it walks. This is called knuckling over and results in the toenails of the rear feet being worn because they drag the ground with each step. It progresses to weakness of the rear legs, then paralysis. It generally takes several weeks b