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The Effect of Post-Operative Rehabilitation on Recovery from Acute Thoracolumbar Intervertebral Disc Herniations

Recovery from spinal cord injury relies in part on the plasticity of the central nervous system. Plasticity is the ability of uninjured parts of the nervous system to take over the functions of parts that have been injured. This process can be enhanced by rehabilitation but the impact of rehabilitation programs in dogs recovering from spinal cord injuries has not been rigorously assessed. The most common cause of spinal cord injury in dogs is an acute intervertebral disc extrusion. The extruded disc material compresses the spinal cord and so dogs undergo a surgery to remove the disc material and decompress the spinal cord. There are concerns that early rehabilitation could negatively impact dog’s recovery from surgery, but these are counterbalanced by studies that suggest starting rehabilitation early is important. This clinical trial was designed in a rigorous fashion to determine whether an intensive rehabilitation program is safe and increases the speed and level of recovery of dogs that were unable to walk, but could still feel their feet after they have had surgery for their acute disc extrusion.

In this blinded, randomized, controlled clinical trial sponsored by Morris Animal Foundation, 30 dogs were randomized to a 2-week staged, intensive rehabilitation protocol or a 2-week basic rehabilitation protocol. The results of the study demonstrated that while the intensive rehabilitation program was safe, it did not influence the speed of recovery in this group of dogs when compared to a more basic rehabilitation protocol. The results of this trial have been accepted for publication by the Journal of Veterinary Internal Medicine.

Looking at the whole group of all 30 dogs, the time to walking was more rapid than that already reported in the literature, raising the question of whether keeping dogs in the hospital under expert care for 2 weeks after their surgery improves their outcome. This deserves further investigation. The question of whether intensive rehabilitation improves outcome for dogs with the most severe grade of injury, paralysis with loss of pain perception, needs to be investigated in a separate trial.