Long term follow up after surgical management of canine chiari malformation with syringomyelia
BVMS, DipECVN, MRCVS
European and RCVS Specialist in Veterinary Neurology
The objective of this retrospective clinical study was evaluate long term success for foramen magnum decompression for management of canine Chiari malformation with syringomyelia (CM/SM) in 15 Cavalier King Charles Spaniels.
After diagnosis of CM/SM by magnetic resonance imaging (MRI) the dogs underwent foramen magnum decompression with either durotomy or expansive duraplasty.
Clinical outcome was monitored for at least 12 months.
All dogs either improved (80%) or were unchanged (20%) post-operatively.
Post-operatively MRI in 6 dogs revealed persistence of syringomyelia, 7 dogs (47%) subsequently deteriorated 0.2 - 2.3 years after surgery (mean 1.3 years) and 2 dogs were eventually euthanized as a consequence, 12 dogs were still alive 1 - 6.5 years after surgery (mean 2.5 years).
This study concluded that foramen magnum decompression surgery has a low morality and morbidity and results in clinical improvement in a majority of dogs. However the procedure does not appear to result in syrinx collapse and resolution, the clinical improvement may not be sustained and a proportion can be expected to deteriorate. This means that foramen magnum decompression surgery has a limited role in the management of CM/SM. In dogs with severe pain it can improve quality of life several years. However it does not adequately address the primary cause of syringomyelia and further study is needed to achieve better understanding of the pathogenesis of this disorder. As this condition causes neuropathic pain but does not necessarily result in euthanasia more information is needed on appropriate analgesia.
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