Treatment of dogs with regard to the peculiarities of pathogenesis of spin-brain trauma

Abstract

Relevance. Damage to the spine and spinal cord in dogs in a city often occur, have a complex pathogenesis of the development of spinal trauma, as a result of which the effectiveness of various methods of providing conservative and operational help is relatively low. Wolman believes that the primary neuropathological factors in spinal cord injury are damage to nerve fibers and vessels, compression and traumatic hemorrhage [1, 5]. Even a relatively small compression of the spinal cord can cause a significant reduction in cerebrospinal blood flow, which is compensated by the mechanism of vasodilation. Violation of cerebrospinal blood flow leads to oxygen starvation of the spinal cord and metabolic disorders [1, p.8].

         One of the factors of conduction disturbance of the spinal cord is demyelination. According to Tatagiba [5, p.12], the concentration of "anti-myelin antibodies" in the area of spinal cord injury is high enough, which leads to destruction by antibodies of intact myelin sheath and expressed tissue necrosis.

         The restoration of the spinal cord occurs through the formation of synapses between the transverse ends of the axon. One of the factors that this impedes is the formation of on-site injuries of coarse glial and connective tissue scars, which creates a mechanical barrier for the further growth of nerve fibers [3, p.15]. The harder the damage to the spinal cord, the greater the connective area.

         The main tasks that need to be performed after spinal cord injury to optimize the recovery processes include eliminating spinal cord compression, reducing the negative impact of secondary pathogenetic factors by administering high doses of methylprednisolone sodium succinate; preventing the depletion of neurotrophic factors in the central nervous system (CNS), preventing the formation of scar tissue in the spinal cord [1, p.19].

         Front spinal syndrome is often diagnosed with spinal cord injuries. It is characterized by incomplete damage and is often encountered during compression fractures of the vertebral bodies, sometimes with their dislocations, and the hernias of the intervertebral discs. Syndrome occurs when common bilateral damage to the spinal cord. Below the level of damage, motor, sensory and autonomic disorders develop. Only vibrational and proprioceptive sensitivity remain preserved. Often syndrome develops as a result of squeezing the anterior cerebellar artery in the vertebral canal. Root syndrome is manifested by a large number of symptoms caused by compression of the cerebrospinal nerves. It is characterized by a pronounced pain effect in that section of the spine, where compression of the spinal roots has arisen. Treatment in case of injuries of the spine and spinal cord involves medication and surgical treatment. The main tasks of surgical treatment with spinal cord injury: decompression of the spinal cord and its roots; stabilization of the spine for the purpose of early immobilization.

The aim of the study is to provide medical aid for various neurological syndromes, resulting from fractures of vertebral bodies, with the progression of the development of herniated intervertebral discs according to the Hunsen classification and the definition of a macroscopic evaluation of the spinal cord state, followed by the formation of a prognosis and treatment methods.

Materials and methods of research. The object of the study were dogs (n = 7) of different breeds and ages: German Shepherd Dog, 6 years old, ♀; German Shepherd Dog, 7 years old, ♂; Central Asian Shepherd Dog, 3 years old, ♀; short hair dachshund, 2 years old, ♀; pug, 3.5 years old, ♂; short-haired dachshund, 4 years old, ♂; French Bulldog, 4 years old, ♀.

         In the study of dogs used: sedatives; neurological hammer; solution of X-ray contrast agent Tomogexol with iodine concentrations of 240 and 300 mg/ml; intravenous catheters Terumo 18-22 G; syringes for 5 and 10 cm³; symptomatic drugs (antihistamines, respiratory analeptics, loop diuretics, analgesics, hemostatic drugs). X-ray apparatus "VATEL-1". Additional surgical instruments and equipment: 2-dimensional pliers, TTM (Germany), tongue holders with rubber rollers; pulse oximeter UT100V; oxygen concentrator "Biomed" 7F-5; intubation tubes with cuffs of different diameters; Ambu pear (medium size).

         For myelography spinal needle Spinosan R. For small animals, the length of the needles was 40 mm, for large ones it was 75 mm.

         For the study, the radiopaque substance Tomogexol was used in concentrations of 240 mg/ml for dogs of the dolichocephalic type and 300 mg/ml for dogs of the brachiocephalic type.

         Neurological Examination Form (2010) was used for neurological examination of dogs, which determines the localization of the pathological process and changes in the nervous system. The main indication for contrast myelography was determining the level of compression of the spinal cord of the intervertebral disc or fragments of the vertebrae during compression fractures.

Results of the study and their discussion. All dogs had a thorough clinical review of the presence of neurological disorders and the presence of paresis and paralysis of the thoracic or pelvic fins. Particular attention was paid to the position of the body in space, pain syndromes when moving on the floor or lying, rigidity of the spine, the presence/absence of involuntary urine excretion.

         After a complete neurological examination, myelographic studies were performed. They introduced a X-ray contrast agent, Tomogexol with a subsequent RTG study of the thoracolumbar spine of the spine to detect herniated intervertebral discs, fragile fractions of the vertebral bodies with their probable hit into the spinal cord. The diagnosis of an intervertebral hernia was based on a clear image of the myelogram with the interruption of the intervertebral disc. Based on radiological data, spinal cord. It turns out that the larger the swelling of the spinal cord, the worse the neurological result [8, p.63].

         Neurological disorders in spinal cord trauma are complex and often do not correlate with morphological disorders in the spinal cord [8, p.36]. Therefore, even a slight compression of the spinal cord to a violation of cerebral circulation in adjacent segments. In these conditions, hypoxic-ischemic events increase.

         Manipulation of the spinal cord during operations in the acute period of trauma reduces to the washing out of detritus with warm saline and should be minimally invasive. Many neurosurgeons with decompressive-stabilizing surgeries on the spine in the acute period of trauma do not open the dura mater [1 p.183]. With RTG signs and clinical symptoms of complete anatomical break of the spinal cord, surgical intervention should be avoided [8, p.83].

Conclusions and prospects.

1. Early diagnostics of vertebral-spinal cord injuries with the use of a neurological protocol, contrast substances and X-ray method allows to determine in time the extent of damage to the thoracolumbar spine and spinal cord. Timely surgical intervention with elimination of the etiological factor creates conditions for restoring the passage of impulse along the nervous tissue and prevents the development of destructive changes.

2. Performing a surgical operation on the axial skeleton requires rather valuable material and technical equipment and monitoring systems for the animal's state during the decompression of the spinal cord or stabilization of the vertebrae during compression fracture. If it is impossible to perform surgery on the spine, it is necessary to use conservative therapy schemes and rehabilitation methods with mandatory restriction of the movements of dogs by keeping them in cages.