Randomized Controlled Trial of Durotomy as an Adjunct to Routine Decompressive Surgery for Dogs With Severe Acute...

Area of Science:

• Veterinary neurology
• Surgical innovation
• Translational research

Background:

• Acute spinal cord injury (SCI) presents challenges in translating experimental treatments to human patients.
• Companion dogs with SCI offer a potential model for bridging this translational gap.
• Durotomy (dural incision) is explored to reduce intraspinal pressure and improve outcomes in SCI.

Purpose of the Study:

• To evaluate the efficacy of durotomy as an adjunct to decompressive surgery for severe thoracolumbar SCI in dogs.
• To determine if durotomy improves functional recovery (ambulation) compared to traditional surgery alone.

Main Methods:

• A multi-center, randomized controlled trial involving 140 dogs with acute thoracolumbar SCI.
• Dogs were assigned to either traditional decompressive surgery or surgery with adjunctive durotomy.
• Functional outcome (ambulation recovery) was assessed over a follow-up period.

Main Results:

• Overall, 51% of dogs recovered ambulation.
• The durotomy group showed a 45% recovery rate, while the traditional surgery group had a 56% recovery rate.
• The trial did not meet its target for improvement and was terminated early due to futility.

Conclusions:

• Durotomy is ineffective in enhancing functional outcomes for dogs with severe acute thoracolumbar SCI.
• These findings contribute to understanding the translational validity of the canine SCI model for human clinical trials.