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Acute adverse events associated with ventral slot decompression in 546 dogs with cervical intervertebral disc disease
Author(s) -
Rossmeisl John H.,
White Courtney,
Pancotto Theresa E.,
Bays Alicia,
HenaoGuerrero P. Natalia
Publication year - 2013
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.2013.12039.x
Subject(s) - medicine , adverse effect , perioperative , neurosurgery , surgery , decompression , anesthesia , retrospective cohort study
Objective To report the frequency, types, and risk factors for acute perioperative adverse events (AEs) in dogs that had ventral slot decompression (VSD) for cervical intervertebral disc disease (IVDD). Design Retrospective, case–control study. Animals Dogs (n = 546) with cervical IVDD treated by VSD; 54 cases experiencing AE and 492 controls. Methods Historical, clinical, diagnostic, operative, and outcome data were collected. AE were graded using a Spine Adverse Events Severity (SAVES) system. Associations between the development of AE and hypothesized risk factors were analyzed using bi‐ and multi‐variable analyses. Results AE were observed in 54 dogs (9.9%). Minor AE (SAVES Grade 1–2) occurred in 3.5% (19 dogs) and major (SAVES Grades 3–5) AE in 6.4% (35 dogs). Deterioration in neurologic status (n = 13), persistent pain (12), and intraoperative hemorrhage (7) were common major AE. NSAID administration, surgeon experience, C7–T1 disc location, and intraoperative hypotension were significantly associated with AE in multivariate analyses. Improvement of AE occurred in 48/54 (88.9%) of cases, although reoperative neurosurgery was required in 48.5% (17/35) of dogs experiencing major AE. Dogs with major AE had significantly longer hospitalization and worse outcomes than dogs with minor AE or controls. No fatal AE occurred, although 0.7% (4/546) of dogs were euthanatized postoperatively. Conclusions AE occurred in 9.9% of dogs that had VSD, and were significantly associated with perioperative hypotension, C7–T1 disc extrusions, surgeon experience, and NSAID usage. Identification of a major postoperative AE is an indication for immediate diagnostic imaging studies, as 50% of dogs experiencing major AE required reoperation.