Rate of neurologic recovery as an indicator of long-term prognosis in dogswith surgically treated thoracolumbar disc disease

The time needed to regain the ability to walk without assistance was examin ed in 266 dogs, from the clinical group of 300 dogs with thoracolumbar disc disease treated by decompressive hemilaminectomy with removal of extruded disc material from the vertebral canal at the Clinic of Surgery and Orthope dics at University of Veterinary and Pharmaceutical Sciences in Brno during a four year period (April 1994 through March 1998). The time needed until complete recovery from TL-IVDD in 177 dogs in which the final outcome was g raded as excellent was also evaluated. The outcome of surgical treatment wa s assessed based on 9 to 51 months follow-up. The time until dogs regained the ability to walk without assistance and until complete recovery (excelle nt outcomes only) differed (Mann-Whitney U-test; p < 0.01) between the grou ps of patients (grade II, III, IV A, IV B and IV C). Evaluating the time ne eded to regain the ability to walk without assistance in relation to the po ssible prediction of complete recovery (patients with excellent result of t herapy compared to patients with very good and fair outcome of surgery) in dogs with grade IV A paraplegia a significant difference (Mann-Whitney U-te st; p < 0.01) was found between patients with very good or fair outcomes an d those with excellent outcomes. In grade IV A dogs, which underwent surger y within 48 hours after the onset of clinical signs, the following results were found: dogs with excellent outcomes regained the ability to walk in 1. 70 +/- 1.14 weeks after surgery, and dogs with very good or fair outcomes r egained the ability to walk in 2.90 +/- 1.47 weeks after surgery. In grade IV A dogs which underwent surgery mon than 48 hours after the onset of sign s, dogs with excellent outcomes regained the ability to walk in 2.15 +/- 1. 69 weeks after surgery, and those with very good or fair outcomes regained the ability to walk in 3.96 +/- 2.29 weeks. Based on these results, the tim e in which a grade IV A dog regains the ability to walk unassisted is an ob jective prognostic indicator with a reliability of 95% (sigma(A)0.95) for t hose operated on within 48 hours from the onset, and also those operated on later than in 48 hours if appropriate decompressive surgery is performed.