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Publication
Resolução de hérnias discais por mínima invasão
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Abstract(s)
É importante sublinhar que as hérnias discais em cães são uma doença relativamente comum. Embora os animais condrodistróficos apresentem uma maior predisposição para contrair a doença, esta afeção também pode afetar raças não-condrodistróficas. No entanto, a apresentação clínica e o respetivo prognóstico são variados. Os cães podem não apresentar sinais clínicos tal como podem desenvolver paresia e paralisia dos membros assim como perda da perceção da dor. Além disso, deve-se ressaltar que a TAC ou a RM confirmam o diagnóstico, podendo ser usado contraste em casos duvidosos e/ou mais complexos. Assim, o tratamento pode ser médico ou cirúrgico, dependendo do grau de comprometimento da medula espinhal e do estado clínico do animal.
O objetivo do presente trabalho foi validar uma nova técnica cirúrgica, apresentando
métodos de abordagem cirúrgica inovadores, minimamente invasivos alternativos aos
métodos clássicos, visando complementar as opções de tratamento das hérnias discais. Assim, realizaram-se duas técnicas endoscópicas, tendo sido feita prévia avaliação clínica e imagiológica.
A mini-hemilaminectomia endoscópica uniportal e a pediculectomia endoscópica
foram as duas técnicas estudadas e realizadas. Ambas permitiram a remoção de material herniado.
Concluindo, é possível remover material discal por mínima invasão, sendo necessário mais estudos em animais vivos para avaliar possíveis limitações desta técnica.
Nos dias de hoje, tem havido cada vez mais preocupação com o bem-estar animal,
sendo fundamental investir e dar preferência a métodos minimamente invasivos.
ABSTRACT - RESOLUTION OF INTERVERTEBRAL DISC HERNIATION BY MINIMAL INVASION - It is noteworthy that intervertebral disc herniation in dogs is a relatively common pathology. Although chondrodystrophic animals show higher predisposition for catching the disease, this pathology can also affect non-chondrodystrophic breeds. However, dogs can manifest multiple clinical prognoses. Even if the dogs don´t show any clinical signs, it is possible to develop paresis and paralysis of the limbs as well as loss of pain perception. Furthermore, it should be noted that CT or MRI confirms the diagnosis, where contrast can be used in dubious and/or more complex cases. In the meantime, it must be mentioned that the treatment can be medical or surgical, depending on the degree of spinal cord involvement and on the clinical status of the animal. The purpose of the current work was to validate a new surgical technique, illustrating innovative surgical procedures, minimally invasive methods of surgical approach alternative to classic methods, aiming to complement the treatment options for herniated discs. Thus, two endoscopic techniques were performed with a previous clinical and imaging evaluation. Uniportal endoscopic mini-hemilaminectomy and endoscopic pediculectomy were the two techniques studied and performed. Both allowed the removal of herniated material. In conclusion, it is possible to remove intervertebral disc material by minimal invasion, but further investigation in live dogs is necessary to discern any clinical limitations to this technique. Nowadays, there has been a significant increase in concern regarding animal welfare, wherefore it is crucial to invest and to give preference to minimally invasive methods.
ABSTRACT - RESOLUTION OF INTERVERTEBRAL DISC HERNIATION BY MINIMAL INVASION - It is noteworthy that intervertebral disc herniation in dogs is a relatively common pathology. Although chondrodystrophic animals show higher predisposition for catching the disease, this pathology can also affect non-chondrodystrophic breeds. However, dogs can manifest multiple clinical prognoses. Even if the dogs don´t show any clinical signs, it is possible to develop paresis and paralysis of the limbs as well as loss of pain perception. Furthermore, it should be noted that CT or MRI confirms the diagnosis, where contrast can be used in dubious and/or more complex cases. In the meantime, it must be mentioned that the treatment can be medical or surgical, depending on the degree of spinal cord involvement and on the clinical status of the animal. The purpose of the current work was to validate a new surgical technique, illustrating innovative surgical procedures, minimally invasive methods of surgical approach alternative to classic methods, aiming to complement the treatment options for herniated discs. Thus, two endoscopic techniques were performed with a previous clinical and imaging evaluation. Uniportal endoscopic mini-hemilaminectomy and endoscopic pediculectomy were the two techniques studied and performed. Both allowed the removal of herniated material. In conclusion, it is possible to remove intervertebral disc material by minimal invasion, but further investigation in live dogs is necessary to discern any clinical limitations to this technique. Nowadays, there has been a significant increase in concern regarding animal welfare, wherefore it is crucial to invest and to give preference to minimally invasive methods.
Description
Dissertação de Mestrado Integrado em Medicina Veterinária
Keywords
Hérnia discal mínima invasão cirurgia mini-hemilaminectomia endoscópica pediculectomia endoscópica intervertebral disc herniation minimally invasive surgery uniportal endoscopic mini-hemilaminectomy endoscopic pediculectomy
Pedagogical Context
Citation
Gusmão RRVA 2021. Resolução de hérnias discais por mínima invasão [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa.
Publisher
Universidade de Lisboa, Faculdade de Medicina Veterinária