Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Electroacupuncture and "Duhuojisheng-tang" Administration for Postoperative Treatment in 3 dogs with Traumatic Spinal Cord Injury

외상성 척수 손상에 대한 척추 수술을 한 3마리의 개에서, 술 후 처치로써 전침과 독활기생탕을 적용한 증례

  • Kim, Min-Su (Department of Veterinary Surgery, College of Veterinary Medicine, Chonbuk National University) ;
  • Kim, Se-Hoon (Department of Veterinary Surgery, College of Veterinary Medicine, Chonbuk National University) ;
  • Cha, Jae-Gwan (Department of Veterinary Surgery, College of Veterinary Medicine, Chonbuk National University) ;
  • Kim, Nam-Soo (Department of Veterinary Surgery, College of Veterinary Medicine, Chonbuk National University) ;
  • Kang, Hyung-Sub (Department of Veterinary Surgery, College of Veterinary Medicine, Chonbuk National University)
  • Accepted : 2011.05.31
  • Published : 2011.06.30
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Abstract

Three dogs with severe traumatic spinal cord injury (TSCI) due to falling wound were admitted to the Veterinary Medical Center, Chonbuk National University for evaluation of severe pelvic limbs paralysis without deep pain, normal defecation and urination. Based on physical examination, neurological assessment and computed tomogram (CT), the diagnosis was made as subluxation and compressed fracture. All the cases were surgically treated with dorsal laminectomy and a spondylosyndesis using pin and bone cements. For 2 weeks, the dogs didn't show any improvement. Consequently, the dogs were treated with electroacupuncture (EA) and Duhuojisheng-tang (DHJST). All the dogs got back the deep pain and presented wagged tail on 14-35 days after starting EA with DHJST. Especially, two of 3 dogs recovered almost normal ambulation and capacities of urination and defecation. But, one dog failed to regain normal ambulation due to inflammation of operative site which is thought to be caused by the bone cement. From these cases, it was thought that the combination of EA and DHJST mightbe one of the suitable therapies in dogs with no neurological improvement.

심한 낙상으로 척수 손상을 입은 개 3 마리가 전북대학교 동물의료센터에 내원을 하였다. 내원을 할 당시 환자는 심부통, 정상적 배변 배뇨 반사가 관찰되지 않았다. 신체 검사, 신경계 검사, 컴퓨터 단층 촬영을 실시한 결과, 흉추의 아탈구와 골절로 진단 되었다. 각각의 증례는 등쪽 척추 후궁 절제술과 척추 고정술을 뼈 시멘트와 스테인만 핀을 이용하여 실시 하였다. 술 후 처치는 약 2 주간 실시하였지만 세 증례에서 신경 증상의 개선이 지연되어 나타났다. 전침과 독활기생탕을 이용하여 환자를 치료하였다. 전침 자극과 독활기생탕 투여 14~45일 후에 세 증례에서 운동성, 고유자세반응, 척추 자세 등이 개선되었으며 심부통이 회복되고 꼬리를 흔들었다. 특히 세 마리 중 두 마리는 거의 정상적인 보행과 배변 배뇨 반사를 나타냈지만 뼈 시멘트로 인한 술부의 염증으로 인하여 치료를 중간에 지연한 1 예에서 경과가 좋지 않았다. 이 증례를 바탕으로 술 후 2 주 이후에도 신경 증상의 개선이 없는 환자에서 전침과 독활기생탕의 적용은 환자의 상태를 개선시킬 수 있는 적당한 치료라 생각된다.

Keywords

References

  1. Besalti O, Ozak A, Pekcan Z, Tong S, Eminaga S, Tacal T. The role of extruded disk material in thoracolumbar intervertebral disk disease: a retrospective study in 40 dogs. Can Vet J 2005; 46: 814-820.
  2. Bethea JR, Castro M, Keane RW, Lee TT, Dietrich WD, Yezierski RP. Traumatic spinal cord injury induces nuclear factor-kappa B activation. J Neurosci 1998; 18: 3251-3260.
  3. BLASS CE, SEIM III HB. Spinal fixation in dogs using Steinmann pins and methylmethacrylate. Vet Surg 1984; 13: 203-210. https://doi.org/10.1111/j.1532-950X.1984.tb00790.x
  4. Chan WW, Chen KY, Liu H, Wu LS, Lin JH. Acupuncture for general veterinary practice. J Vet Med Sci 2001; 63: 1057-1062. https://doi.org/10.1292/jvms.63.1057
  5. Choi KH, Hill SA. Acupuncture treatment for feline multifocal intervertebral disc disease. J Feline Med Surg 2009; 11: 706-710. https://doi.org/10.1016/j.jfms.2008.11.013
  6. Dumont RJ, Okonkwo DO, Verma S, Hurlbert RJ, Boulos PT, Ellegala DB, Dumont AS. Acute spinal cord injury, part I: pathophysiologic mechanisms. ClinNeuropharmacol 2001; 24: 254-264.
  7. Hayashi AM, Matera JM, Fonseca Pinto AC. Evaluation of electroacupuncture treatment for thoracolumbar intervertebral disk disease in dogs. J Am Vet Med Assoc 2007; 231: 913-918. https://doi.org/10.2460/javma.231.6.913
  8. Hayashi AM, Matera JM, da Silva TS, Pinto AC, Cortopassi SR. Electro-acupuncture and Chinese herbs for treatment of cervical intervertebral disk disease in a dog. J Vet Sci 2007; 8: 95-98. https://doi.org/10.4142/jvs.2007.8.1.95
  9. Janssens LA. Acupuncture for the treatment of thoracolumbar and cervical disc disease in the dog. Probl Vet Med 1992; 4: 107-116.
  10. Kim NS, Lee CH, Lee JI, Park YJ, Lee BG, Choi IH. Acupuncture therapy of $T_{12}-L_1$ intervertebral disk disease in dogs. J Vet Clin 2004; 21: 380-383.
  11. Kim SY, Kim MS, Seo KM, Nam TJ. Effect of the Combination of Electroacupuncture and Surgical Decompression on Experimental Spinal Cord Injury in Dogs. J Vet Clin 2005; 22: 297-301.
  12. Kube SA, Olby NJ. Managing acute spinal cord injuries. Compend Contin Educ Pract Vet 2008; 30: 496-504.
  13. Lorenz MD, Kornegay JN. Pelvic Limb Paresis, Paralysis, or Ataxia. In: Handbook of veterinary neurology. New York: Saunders. 2004: 131-174.
  14. Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. Am J Neuroradiol 2001; 22: 373-381.
  15. Olby NJ. Current concepts in the management of acute spinal cord injury. J Vet Intern Med 1999; 13: 399-407. https://doi.org/10.1111/j.1939-1676.1999.tb01453.x
  16. Olby NJ, Levine J, Harris T, Munana K, Skeen T, Sharp N. Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001). J Am Vet Med Assoc 2003; 222: 762-769. https://doi.org/10.2460/javma.2003.222.762
  17. Olby NJ, Harris T, Burr J, Munana K, Sharp N, Keene B. Recovery of pelvic limb function in dogs following acute intervertebral disc herniations. J Neurotrauma 2004; 21: 49-59. https://doi.org/10.1089/089771504772695940
  18. Park WH. An influence of the Dokhwalgisangtang aqueous solution on the galactosamine-induced hepatotoxicity in rat. J Orient Physiol 1997; 11: 118-125.
  19. Sherman J, Olby NJ. Nursing and rehabilitation of the neurological patient. In: BSAVA Manual of canine and feline neurology, 3rd ed. Gloucester: British Small Animal Veterinary Association. 2004: 394-407.
  20. R Roaf. A study of the mechanics of spinal injuries. J Bone Joint Surg Br 1960; 42: 810-823.
  21. Scott HW, McKee WM. Laminectomy for 34 dogs with thoracolumbar intervertebral disc disease and loss of deep pain perception. J Small Anim Pract 1999; 40: 417-422. https://doi.org/10.1111/j.1748-5827.1999.tb03114.x
  22. Selcer RR, Bubb WJ, Walker TL. Management of vertebral column fractures in dogs and cats: 211 cases (1977-1985). J Am Vet Med Assoc 1991; 198: 1965-1968.
  23. Sturges BK, LeCouter RA. Vertebral fracture and luxations. In: Textbook of small animal surgery. Philadelpia: WB Saunders. 2002: 1244-1260.
  24. Xie H, Ortiz-Umpierre C. What acupuncture can and cannot treat. J Am Anim Hosp Assoc 2006; 42: 244-248. https://doi.org/10.5326/0420244
  25. Xie H, Ott EA, Colahan P. Influence of acupuncture on experimental lameness in horses. Proc Annu Conv AAEP 2001; 47: 347-357.
  26. Xie H, Preast V. Acupuncture for treatment of musculoskeletal and neurological disorders. In: Xie's veterinary acupuncture. Iowa: Blackwell Publishing. 2008: 247-266.
  27. Xie H, Ott EA, Harkins JD, Tobin T, Colahan PT, Johnson M. Influence of electro-acupuncture on pain threshold in horses and its mode of action. J Equine Vet Sci 2001; 21: 591-600. https://doi.org/10.1016/S0737-0806(01)80020-4
  28. Yang JH, Jeong SM, Seo KM, Nam TC. Effects of corticosteroid and electroacupuncture on experimental spinal cord injury in dogs. J Vet Sci 2003; 4: 97-101.