人和狗颈部椎管狭窄的临床和形态计量学比较研究

IF 0.5 Q4 BIOLOGY Regulatory Mechanisms in Biosystems Pub Date : 2022-08-16 DOI:10.15421/022239
T. Andreyeva, O. Stoyanov, G. Chebotaryova, R. Vastyanov, V. Kalashnikov, A. O. Stoyanov
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The mass proportion of stenotic changes of the spinal canal against the background of the degenerative-dystrophic process was 21 in males (n = 25) 84.0%, females – 28 persons (n = 40) 70.0%. Pain syndrome was the main complaint in all patients. Cervicalgia prevailed in 60 (92.3%), pain in the upper back was registered in 32 (49.2%) patients. The intensity of pain syndrome was equal to 3.1 ± 0.4 points. Motor deficiency in the form of paresis, mainly of the distal parts of the hands, was registered in 48 patients (73.8%), pyramidal symptoms were noted in the legs in 32 (49.2%) patients, pelvic reservoir dysfunction (7.0–10.8%), and sensory disorders were also found (24.0–36.9%). Such manifestations of cervical myelopathy progressed slowly. Pyramidal symptoms were more frequent and more pronounced in men. 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Narrowing of the intervertebral openings, deformation and sclerotic changes of the locking plates, thickening of the yellow and elongated ligaments occurred three to four times more in large breeds compared to dogs weighing less than 20 kg, and were absent in cats. Stenosis of the spinal canal was detected in 15 (78.9%) dogs. Therefore, acquired stenosis of the spinal canal probably develops after degenerative-dystrophic changes in the neck in 87.7% of people and in 78.9% of dogs with clinical manifestations of cervical myelopathy and with persistent pain syndrome (equal to 3.1 ± 0.3 points in humans and 2.6 ± 0.4 points in animals according to visual analog scale). This kind of pathological process in the investigated groups developed mainly at the level of the C6 vertebra. Similar clinical and morphometric indexes were obtained in humans (87.7%). It was found that the maximum similarity of pathological processes with stenosis of the spinal canal formation was characteristic in dogs of exclusively large breeds. Therefore, we consider it promising to study the development mechanisms of stenosis of the spinal canal and peculiarities primarily in young generations of humans and animals, to implement modern non-invasive neuroimaging methods, in particular for animals with investigation of morphometric indexes. This will prevent the occurrence of most comorbid syndromes, including chronic pain, neurological deficits as well as help find new opportunities for correction of stenosis of the spinal canal, to suppress the aging processes not only of the muscle-skeletal system but also of the body as a whole. 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引用次数: 0

摘要

获得性椎管狭窄是人类和动物病理学中常见的问题。它被定义为一种病理状况,主要发展为脊柱退行性变伴颈脊髓病的发展,这是这种病理的特征性表现。颈部和上背部疼痛是这种病理的主要综合征。对65名年龄在20-65岁之间的人类患者和19只体重超过20公斤的狗进行了检查,目的是对椎管狭窄的临床和形态计量学进行比较分析。狗的年龄最大限度地换算成一个人的年龄。使用Pavlov-Torg指数和保留空间评估的计算机断层扫描补充了椎管狭窄的诊断。在退行性营养不良过程的背景下,椎管狭窄变化的质量比例为男性21人(n=25)84.0%,女性28人(n=40)70.0%。疼痛综合征是所有患者的主要主诉。60例(92.3%)患者出现颈痛,32例(49.2%)患者出现上背部疼痛。疼痛综合征的强度为3.1±0.4分。48名患者(73.8%)出现了以轻瘫形式出现的运动功能障碍,32名患者(49.2%)出现了腿部锥体细胞症状,还发现了骨盆储液器功能障碍(7.0-10.8%)和感觉障碍(24.0-36.9%)。颈脊髓病的这些表现进展缓慢。金字塔型症状在男性中更为常见和明显。根据计算机断层扫描,C6脊椎的退行性变化最大,具有最大的临床相关性(神经系统缺陷、疼痛综合征等)。在研究过程中,在计算机断层扫描图像上发现人们可能存在椎管狭窄。在观察到的19只体重20公斤或以上的狗中,所有动物都评估了疼痛综合征的存在(100.0%)以及行为变化(100.0%。在检查过程中,检测到步态障碍(18.0-94.7%);颈部触诊反应(15.0-78.9%);经历疼痛的动物的习惯,尤其是在颈部运动(14.0-73.7%)、身体紧张(12.0-63.1%)等过程中。与其他犬种相比,几乎所有18只(94.7%)大型犬种的脊椎和椎间关节边缘都有骨质突起。与体重低于20公斤的狗相比,大型犬的椎间孔变窄、锁定板变形和硬化变化、黄色和细长韧带增厚的发生率高出三到四倍,而猫则没有。在15只(78.9%)狗中检测到椎管狭窄。因此,在87.7%的人和78.9%的狗的颈部退行性营养不良改变后,获得性椎管狭窄可能会发展,这些人和狗的临床表现为颈脊髓病和持续疼痛综合征(根据视觉模拟量表,人类为3.1±0.3分,动物为2.6±0.4分)。研究组的这种病理过程主要发生在C6椎体。在人类身上获得了相似的临床和形态测量指标(87.7%)。研究发现,病理过程与椎管形成狭窄的最大相似性是大型犬的特征。因此,我们认为研究椎管狭窄的发展机制和主要在年轻一代人和动物中的特点,实施现代非侵入性神经成像方法,特别是对研究形态计量学指标的动物,是有希望的。这将防止大多数共病综合征的发生,包括慢性疼痛、神经系统缺陷,并有助于找到矫正椎管狭窄的新机会,不仅可以抑制肌肉骨骼系统的衰老过程,还可以抑制整个身体的衰老过程。我们认为,这项工作的重要性在于,在不同品种和体重类别的椎管狭窄动物中,进一步确定适当的模型,使其发展得更快,从而推断出人类来预测病理事件的发展。
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Comparative clinical and morphometric investigations of cervical stenosis of the spinal canal in humans and dogs
Acquired stenosis of the spinal canal is a common problem in human and animal pathology. It is defined as a pathological condition that mainly develops as degeneration of the spine with cervical myelopathy development, which is a characteristic manifestation of this pathology. Pain both in the neck and upper back is the leading syndrome of this pathology. 65 human patients aged 20–65 years and 19 dogs weighing more than 20 kg were examined with the aim of comparative clinical and morphometric analysis of stenosis of the spinal canal. The age of the dogs was maximally converted to the age of a person. Computed tomography using the Pavlov-Torg index and the reserve space evaluation supplemented diagnosis of stenosis of the spinal canal. The mass proportion of stenotic changes of the spinal canal against the background of the degenerative-dystrophic process was 21 in males (n = 25) 84.0%, females – 28 persons (n = 40) 70.0%. Pain syndrome was the main complaint in all patients. Cervicalgia prevailed in 60 (92.3%), pain in the upper back was registered in 32 (49.2%) patients. The intensity of pain syndrome was equal to 3.1 ± 0.4 points. Motor deficiency in the form of paresis, mainly of the distal parts of the hands, was registered in 48 patients (73.8%), pyramidal symptoms were noted in the legs in 32 (49.2%) patients, pelvic reservoir dysfunction (7.0–10.8%), and sensory disorders were also found (24.0–36.9%). Such manifestations of cervical myelopathy progressed slowly. Pyramidal symptoms were more frequent and more pronounced in men. According to the computed tomography scan, degenerative changes of the spine were maximal at the level of the C6 vertebra with the maximum clinical correlation (neurological deficit, pain syndrome, etc.). In the course of the research, probable stenosis of the spinal canal was found in people on computed tomography images. In the 19 dogs observed weighing 20 kg or more the presence of pain syndrome was evaluated in all the animals (100.0%) as well as behaviour change (100.0%). During the examination, gait disorder was detected (18.0–94.7%); reaction to palpation of the neck area (15.0–78.9%); the habitus of animals experiencing pain, especially during neck movements (14.0–73.7%), body tension (12.0–63.1%), etc. Bony outgrowths of the edges of the vertebrae and intervertebral joints were found in almost all dogs of 18 (94.7%) large breeds compared to others. Narrowing of the intervertebral openings, deformation and sclerotic changes of the locking plates, thickening of the yellow and elongated ligaments occurred three to four times more in large breeds compared to dogs weighing less than 20 kg, and were absent in cats. Stenosis of the spinal canal was detected in 15 (78.9%) dogs. Therefore, acquired stenosis of the spinal canal probably develops after degenerative-dystrophic changes in the neck in 87.7% of people and in 78.9% of dogs with clinical manifestations of cervical myelopathy and with persistent pain syndrome (equal to 3.1 ± 0.3 points in humans and 2.6 ± 0.4 points in animals according to visual analog scale). This kind of pathological process in the investigated groups developed mainly at the level of the C6 vertebra. Similar clinical and morphometric indexes were obtained in humans (87.7%). It was found that the maximum similarity of pathological processes with stenosis of the spinal canal formation was characteristic in dogs of exclusively large breeds. Therefore, we consider it promising to study the development mechanisms of stenosis of the spinal canal and peculiarities primarily in young generations of humans and animals, to implement modern non-invasive neuroimaging methods, in particular for animals with investigation of morphometric indexes. This will prevent the occurrence of most comorbid syndromes, including chronic pain, neurological deficits as well as help find new opportunities for correction of stenosis of the spinal canal, to suppress the aging processes not only of the muscle-skeletal system but also of the body as a whole. The importance of this work, we suppose, lies in the further identification of adequate models in animals of different breeds and weight categories with stenosis of the spinal canal pathology in which it develops significantly faster, for extrapolation to humans to predict the development of pathological events.
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