Associations between cerebrospinal fluid biomarkers and long-term neurologic outcome in dogs with acute intervertebral disk herniation

摘要

OBJECTIVE: To examine associations between CSF biomarkers, initial neurologic dysfunction,and long-term ambulatory outcome in dogs with acute intervertebral disk herniation (IVDH).DESIGN: Prospective clinical study.ANIMALS: 54 dogs with acute thoracolumbar IVDH and 16 clinically normal dogs.PROCEDURES:For each dog, variables, including CSF myelin basic protein (MBP), lactate,calcium, glucose, and total protein concentrations; nucleated cell count; and creatine kinase(CK) and aspartate aminotransferase activities, were measured. For dogs with thoracolumbarIVDH, initial neurologic function was characterized by use of a modified Frankelscore (MFS; determined on a scale of 0 to 5, where 0 represented paraplegia with no deepnociception and 5 represented paraspinal hyperesthesia only). Long-term follow-up wasassessed.RESULTS: Among dogs with thoracolumbar IVDH, those with CSF CK activity ≤ 38 U/L hada 35-fold increase in the odds of long-term ambulation, compared with the odds in dogswith CSF CK activity > 38 U/L, adjusting for neurologic functioning at the evaluation. TheCSF lactate, calcium, and glucose concentrations and aspartate aminotransferase activitywere not predictive of long-term ambulatory outcome. Data analysis revealed that longtermfunctional recovery was > 98% for affected dogs, regardless of their initial MFS, whenCSF CK activity was ≤ 38 U/L and MBP concentration was ≤ 3 ng/mL.CONCLUSIONS AND CLINICAL RELEVANCE: In dogs with acute thoracolumbar IVDH, CSF CKactivity and MBP concentration appeared to be prognostic indicators and, along with initialMFS, can be used to predict long-term ambulatory outcome. (J Am Vet Med Assoc2012;240:555–562)