A 50-step walking test for analysis of recovery after decompressive surgery for thoracolumbar disc herniation in dogs.
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BACKGROUND: Despite its importance, there is no agreed definition of recovery of ambulation in dogs with spinal cord injury. OBJECTIVES: To validate a new walking test in dogs recovering from thoracolumbar spinal cord injury. ANIMALS: Two hundred twenty-four dogs weighing <20kg: 120 normally ambulatory dogs, plus 104 dogs undergoing decompressive surgery for acute thoracolumbar intervertebral disc herniation. METHODS: Prospective cohort studies. The distance each freely-ambulatory dog walked during 50 step cycles was regressed on ulna length. For each postsurgical dog, we recorded when the calculated 50-step distance was completed without falling, or their inability to complete this distance by 4months or more after surgery. Bayesian analysis compared outcomes for presurgical neurologic categories; association of recovery with several preoperative variables was explored using logistic and time-to-event regression. RESULTS: For control dogs, 50-step distance (m)=1.384 ulnar length (cm)+2.773. In postsurgical dogs, the 50-step test provided decisive evidence that deep pain-negative dogs were less likely to recover ambulation than dogs with intact pain perception (12/29 recovered vs 71/75; Bayes factor [BF]=5.9 106 ) and, if they did recover, it took much longer (median 91days vs median 14days; BF=1.5 103 ). Exploratory analysis suggested that presurgical neurologic status (subhazard ratio [SHR]=0.022; P<.001) and duration of presurgical anesthesia (SHR=0.740; P=.04) were associated with rapidity of recovery. CONCLUSIONS AND CLINICAL IMPORTANCE: This straightforward 50-step walking test provides robust data on ambulatory recovery well-suited to large scale pragmatic trials on treatment of thoracolumbar spinal cord injury in dogs.
