Single dose epidural methylprednisolone as a treatment and predictor of outcome following subsequent decompressive surgery in degenerative lumbosacral stenosis with foraminal stenosis

Gomes, S. A.; Lowrie, M.; Targett, M.

Abstract

© 2020 Elsevier Ltd Alternative treatments to surgery in canine degenerative lumbosacral stenosis (DLSS) remain limited and reliable predictors of outcome are lacking. The aims of this clinical trial were threefold: to assess the usefulness of single epidural steroid injection (ESI) in DLSS, to compare the outcomes of ESI and decompressive surgery, and evaluate ESI as a predictor of outcome following decompressive surgery. Dogs diagnosed with DLSS were prospectively recruited and administered an ESI. If clinical signs persisted or relapsed, decompressive surgery was recommended. Follow-up was obtained. Thirty-two dogs underwent ESI with 17 having subsequent surgery. Improvement after ESI was seen in 27/32 dogs (84.4%), with 17/22 (77.2%) relapsing within 6 months (n = 15/17 relapsing within 2 months). Five dogs failed to respond to ESI and another five (15.6%) presented a persistent post-ESI favourable response (mean follow-up time, 9.4 months). Post-surgical improvement occurred in all dogs. Outcome appeared more favourable following surgical decompression, with a trend towards reduced pain, increased mobility, and greater quality of life score. This study was unable to demonstrate that ESI could predict surgical outcome. ESI was confirmed as an effective treatment in most but not all cases, leading to transient alleviation of clinical signs for longer than previously reported. ESI provided a complete and apparently long-term sustained resolution of clinical signs in a subset of dogs. Despite this, there was indication that surgical decompression can lead to a more favourable outcome. Epidural steroid injection has a role in the management of DLSS dogs, particularly when surgery is not an option.

Citation

Gomes, S. A., Lowrie, M., & Targett, M. (2020). Single dose epidural methylprednisolone as a treatment and predictor of outcome following subsequent decompressive surgery in degenerative lumbosacral stenosis with foraminal stenosis. Veterinary Journal, 257, https://doi.org/10.1016/j.tvjl.2020.105451

• Journal Article Type: Article
• Acceptance Date: Mar 25, 2020
• Online Publication Date: Mar 30, 2020
• Publication Date: Mar 1, 2020
• Deposit Date: Apr 27, 2020
• Publicly Available Date: Mar 2, 2021
• Journal: Veterinary Journal
• Print ISSN: 1090-0233
• Electronic ISSN: 1532-2971
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 257
• Article Number: 105451
• DOI: https://doi.org/10.1016/j.tvjl.2020.105451
• Keywords: Animal Science and Zoology; General Veterinary
• Public URL: https://nottingham-repository.worktribe.com/output/4348793
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1090023320300289?via%3Dihub
• Additional Information: This article is maintained by: Elsevier; Article Title: Single dose epidural methylprednisolone as a treatment and predictor of outcome following subsequent decompressive surgery in degenerative lumbosacral stenosis with foraminal stenosis; Journal Title: The Veterinary Journal; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.tvjl.2020.105451; Content Type: article; Copyright: © 2020 Elsevier Ltd. All rights reserved.