狗腰间盘突出

1、Degenerative Disc Disease in Dogs狗锥间盘突出Degenerative Disc Disease in DogsPet IWhat is a disc, and what is its purpose?椎间盘及其功能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.椎间盘 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.脊髓是动物体内最重要、最敏感的器官系

4、统之一，一旦损坏，脑神经细胞将不能修复再生，从而变为纤维和疤痕组织。脊髓损伤通常是永久不可逆的。为保护脊髓免受损伤，脊髓在椎管内向后延伸（由所有的椎骨按前后顺序连接一起形成的一个连续的管道），通过椎间孔进出椎管。椎骨通过类似橡胶垫的具有弹性的椎间盘来连接。通过这种结构，单个椎骨和椎间盘让背上下左右活动而避免了椎骨之间接触。这种保护脊髓的方式使得脆弱的椎间盘具有重要的作用。What does it mean for a disc to rupture, and how does it happen?椎间盘突出及其发生The disc is composed of two parts. 椎间盘是由

5、两部分组成。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. 椎间盘是由两部分构成。外层(纤维环)是一个厚的壳，它是由坚硬的纤维构成，保护并包含中央部分髓核 。髓核部分最薄，位于脊髓正下方，比外层柔软并富有弹性。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. 椎间盘变性性疾病导致自发退变的椎间盘，导致突然椎间盘破裂或突出症 (也称为椎间盘突出) 。它可能与受伤无关，虽然在某种外部创伤后，如跌倒或小幅度跳跃后会经常发生。这经常被认为是椎间盘破裂，实际上损伤的发生是由于慢性椎间盘退变。大多数狗发生椎间盘退行性疾病在中年（三至七岁）。可能是这种疾病的遗传易感性，有些品种，尤其是腊肠犬、 贵宾犬、 狮子狗、 拉萨犬、 德国牧羊犬、 杜宾犬和可卡犬发病率高。Because the spinal cord is encased within its bony canal, it cannot move awa

10、y from the pressure and it becomes pinched.因为脊髓固定在椎管内，不可避免的受到脱出的椎间盘的挤压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.当纤维环变性后，中央的髓核从裂缝脱出。髓核柔软富有弹性，可凸入脊髓并产生压迫，因为脊髓固定在椎管内，不能避开破损的椎间盘，从而受到“挤压”。How does a slipped disc affect the spinal cord?突出的椎间盘如何影响脊髓？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. 脊髓是像电话线包裹许多微细的光缆。当它被挤压损伤时，信号通过神经传递的速度会减慢甚至停止。当椎间盘脱出，会挤压进出脊髓的神经 (即脊神经)。脊髓神经受压力导致疼痛。压迫脊髓导致疼痛或信号损失，导致局部或全身瘫痪。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. 大多数的椎间盘破裂发生在背的中后部，但是也可能发生在颈部。背部椎间盘损伤经常导致瘫痪不会伴剧烈疼痛，颈部损伤通常会剧烈疼痛但不会瘫痪。如果瘫痪后四肢都受到影响，椎间盘损伤必然发生在颈部。由于神经在脊髓上的走行，颈部椎间盘破裂可能首先影响后肢不影响前肢。（这一段翻译的可能有大问题）How fast do intervertebral discs degenerate and rupture?椎间盘发生

16、退行性变和突出需要多久？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. 椎间盘退变发生相对较慢，破裂逐渐出现，以致在几天或几周时间内退变的髓核慢慢从椎间盘滑出。这时你的狗会经常疼痛并不愿活动。它可能是想尝试休息几天时间让身体的损伤恢复，往往没有意识到问题的存在。Some dogs will go from normal walking to total paralysis in less than one hour. 有些看起来正常的狗狗会在短短一个小时之内忽

18、然全身瘫痪。However, discs may also rupture very acutely. Some dogs will go from normal walking to total paralysis in less than one hour. 然而，椎间盘退变发生可能也很剧烈。有些看起来正常的狗狗会在短短一个小时之内忽然全身瘫痪。How is a slipped disc diagnosed?椎间盘突出如何诊断？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. 初步诊断时椎间要了解狗狗在近期的外伤后有没有颈部或背部疼痛、 行走不协调协调或者瘫痪的症状。如果狗狗是发病率高的品种之一，在这些症状下，狗狗患腰间

20、盘突出的可能性会很高。.a myelogram may be performed.X光片诊断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. 在某些情况下，光片 (x 射线) 可协助诊断。然而，光片可能会显示无异常，因为椎间盘和脊髓都不都在 x 线下观察。如果对诊断有疑问，可以通过手术观察。此过程需要向麻醉后犬的脊髓周围注射特殊染料，然后采取多次的射线成像。染料可将脊髓的轮廓在x射线下显示。染料轮廓破损的部位就表明着脊髓在那一点受到压迫。如果可以用计算

23、机断层扫描 (CT) 和磁共振成像 (MRI) 可用于诊断椎间盘突出症。How do you know if the pressure on the spinal cord is due to a disc or something else?如何判断脊髓压迫是椎间盘突出引起的？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压迫也可能是由于血液阻塞或肿瘤，但是与椎间盘突出相比可能性极小。如果狗狗是该病的高发品种并且有过在未受严重创伤的情况下突发麻痹，那

25、么95%的可能是椎间盘破裂导致的临床症状。然而，在手术之前并不能确诊。Are all disc ruptures treated with surgery?所有的椎间盘突出都必须手术进行治疗吗？Not necessarily. The recommended treatment is based on the stage of the disease: 不是必须的，我们建议治疗方法要依据椎间盘突出发生的程度 : 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. 第一阶段 产生中度疼痛，通常在几天内自愈。 第二阶段 导致颈腰部（背部）中度至重度疼痛。 第三阶段 导致局部麻痹 (麻痹)，遛狗时会发现狗狗运动不协调或者行走不稳。 第四阶段 造成瘫痪但有知觉。 第五阶段 造成瘫痪并丧失知觉。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. 这些阶段往往是不同程度同时叠加的，狗狗可能会从一个阶段进入到另一个阶段只要几个小时或几天天。第二阶段和第三阶段的患病狗狗通常用消炎药，止痛药治疗，并限制狗狗的活动。如果疼痛或运动不协调的症状在治疗47天后仍然不减，或神经系统的状态从一天天下降，就可能需要手术。具体发生时间会因每只狗狗的病情而异。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. 第四阶段的疾病犬应该采取手术，即使仍有恢复的机率（不动手术）。第五阶段疾病的犬应该立即做手术，越早越好，最理想的是在发病的 24 小时内做手术。What

31、 is the purpose of surgery? 手术目的是什么？The goal of surgery is to remove pressure from the spinal cord. 手术目的是解除脊髓压迫。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. 手术目的是解除脊髓压迫。如果椎间盘突出发生在背后半部，一个开口(称为开窗) 进行椎体骨侧暴露脊髓。通过窗口将突出的髓核去除，减轻脊髓受压。如果椎间盘突出发生在颈部，开窗口暴露脊髓骨可以从顶部或底部，可根据情况和兽医的偏好选定。What is the success rate for treating disc disease with and without surgery? 手术治疗和不经手术治疗痊愈的机率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% 阶段无需手术的恢复手术恢复I: 一周内80-90%90-95%II: 一周后60-70%90-95%III 30-40%85-95%IV: 三天内 25%85-95%IV: 三天后 20%60-70%V: 24h内 5%50%V: 24h后 5% 20%When will we know i

35、f the surgery is successful?何时判断手术是否成功？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.很遗憾，手术是否成功并不能很快判断，神经元的恢复、行走能力以及疼痛的的减轻都不能在手术后短短几天或几个星期之内见效。When can my dog go

36、 home?我们的狗手术后多久能出院回家？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.经过手术，你的狗狗将住院几天。当狗狗瘫痪，消化和泌尿系统功能较低。最好让你的狗继续住院，直到身体各项机能恢复。不过通常

38、延长住院时间不要超过七天，因为恢复行走能力一部分取决于运动和恢复动力。因为动力是重要的恢复过程，我们鼓励您手术后多去医院看望您的狗。 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. 恢复取决于

39、四个因素: 手术是否永久性损伤，手术减轻一些压力不够快，如果可以在家里进行物理治疗，如果这只狗是动机来恢复.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.如果手术前就已经瘫痪，你的狗可能不能走路时它出院。你会应执行的程序给予详细的说明。恢复是取决于四个因素: 是否永久性损伤过手术，如果手术减轻一些压力不够快，如果可以在家里进行物理治疗，如果这只狗是动机来恢复。Can my dog slip

41、a disc again?我家狗手术后会不会复发？The answer is yes. However, as discussed above, not all disc herniations require surgery. 答案是肯定。然而，如上文所讨论，并不是所有的椎间盘突出都需要手术。What if the myelogram is normal?如果脊髓造影显示正常怎么办？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: 脊髓造影的目的是确诊脊髓压迫，如果脊髓造影显示正常，没有压迫神经，那就会有以下几种可能。1.一般不需要手术来治疗；2.它可能存在以下问题: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。这是创伤导致的脊髓

44、功能暂时丧失。它通常会突然发生，某种程度上类似于脑震荡。它可能造成永久性损伤也可能完全恢复。从脊髓休克的复苏通常会发生在几个小时内，或几天内。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 made by performing a spinal cord biopsy after death. 纤维软骨栓塞。在这种情况下，极少量的椎间盘内容物破裂并进入血管导致脊髓损伤。血管微细被椎间盘内容物阻塞，从而导致某些部位血液运输受到影响，这些部位的脊髓得不到血液的供应而死亡，导致瘫痪。这时候手术不能帮助小狗，因为这不是椎间盘脱出导致的脊髓压迫。通常情况下，只会瘫痪一只后肢或一只后肢比其他条腿严重。完全恢复可能会需要几天到几周的时间，也可能脊髓的某