Intervertebral disk disease is a common problem characterized by premature hardening of the nucleus pulposus of the vertebral disk associated with a weakness of the annulus fibrosus. This condition can lead to herniation of the nucleus pulposus against the spinal cord, causing pain, inflammation, and subsequent neurologic symptoms. This study evaluated the differences between treatments of dogs with severe neurologic symptoms secondary to intervertebral disk herniation. All dogs developed clinical signs > 48 hours before presentation. Ten dogs treated with decompressive surgery were retrospectively selected. Thirty dogs were prospectively evaluated after undergoing electroacupuncture (n = 19) or decompressive surgery followed by electroacupuncture (n = 11). Myelopathy scoring was performed before and after treatment. Treatment was considered a clinical success if a patient improved to the lowest grade of clinical dysfunction (pain only in the vertebral region with no abnormal neurologic signs, ability to bear weight with deficits of proprioception and ambulatory paraparesis), were able to walk without assistance, or recovered deep pain perception by 6 months. Only 4 of 10 dogs that underwent decompressive surgery showed improved neurologic function by 6 months after surgery. This proportion was significantly less than dogs that improved in the electroacupuncture or the surgery plus electroacupuncture groups. The proportion of dogs with no change in myelopathy scores by 6 months after treatment did not differ between the electroacupuncture and the surgery plus electroacupuncture groups. The authors concluded that patients did better with nonsurgical intervention if they presented with severe neurologic symptoms that had existed for longer than 48 hours. Electroacupuncture alone may be a good approach for conservative treatment of dogs with disk disease and severe neurologic dysfunction if surgery is not an option because of financial or logistic reasons.
Commentary: Acupuncture is becoming more popular in science-based veterinary medicine, but its effectiveness remains controversial. This study presented potentially ground-breaking information and should be considered in future research to help fully understand the mechanisms and benefits behind electroacupuncture. Veterinary patients with intervertebral disk disease and no deep pain perception are often euthanized, so awareness of novel approaches to recovery is very important. More work with more patients is needed to assess the benefits and disadvantages of this technique.
Comparison of decompressive surgery, electroacupuncture, and decompressive surgery followed by electroacupuncture for the treatment of dogs with intervertebral disk disease with long-standing severe neurologic deficits. Joaquim JG, Luna SPL, Brondani JT, et al. JAVMA 236:1225-1229, 2010.