Myelomalacia and other complications after spinal surgery

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Category: Neurology Club
Published on: 01.02.2018

Presenter:

Lorenzo Golini DVM MSc Dip ECVN MRCVS
RCVS specialist in Veterinary Neurology 

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About The Webinar

Myelomalacia and other complications after spinal surgery is a brief overview about the most common major and minor complications that could arise in the immediate and long term post-operative period. Major complications are these that would result in the death of the patient (i.e. myelomalacia) or reoperation and elongation of the hospitalization period (i.e. disc recurrence, hemorrhages, and deep infections/discospondylitis). Minor complications are these that could be medically managed and might results in transient discomfort to the patient (i.e. ocular pathologies, superficial skin infections, or UTI). Myelomalacia is defined a softening of the spinal cord due to continuous hemorrhagic and necrosis. This is normally irreversible and unstoppable, it is mainly happening in dogs that do loose the nociception at admission and within 48 hours from the appearance of the clinical signs. In few cases, myelomalacia is a more chronic approach affecting dogs also 3 weeks after initial spinal cord damage and with motor function and/or presence of nociception. Recurrence of intervertebral disc disease is another common complication that could happen as soon as 3 days after initial surgery or as late as 61 months. Power fenestration will reduce this occurrence but not avoid completely it. Superficial (skin and fascial) and deep (discospondylitis) infection are common problems. The first is present despite the administration of antimicrobial prophylaxes, the discospondylitis is less common and require reoperation when deterioration of the clinical signs is observed. GI complication are mainly related to the administration of steroids, especially because dogs with IVDD have higher incidence of stress induced gastric and/or duodenal ulcers. UTI are common even in absence of leukocytosis in urine and this could last for longer than few weeks. Corneal erosion could be observed despite use of prophylactic use of tear replacement application and if not appropriately treated could hesitate in severe ocular side effects.

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