Page 142 - Veterinary Laser Therapy in Small Animal Practice

128 Veterinary Laser Therapy in Small Animal Practice

Table 9.4 Modified Frankel Score (MFS). newly formed elastic fibers in their intervertebral
disks. [369] A clinical trial in people with chronic
Grade Neurological deficit
0 Tetra/paraplegia with no deep nociception lower back pain found LT to be more effective as an
[370]
analgesic treatment than magnetic field therapy.
Tetra/paraplegia with deep nociception but no
1 In practice, this combination of LT and magnetic
superficial nociception field therapy is quite common and seems to have an
2 Tetra/paraplegia with entire nociception additive effect.
3 Non-ambulatory tetra/paraparesis
4 Ambulatory tetra/paraparesis and/or ataxia Consider shaving or trimming the hair to improve
5 Spinal hyperesthesia only (no dysfunction) penetration, especially with very thick dark coats.
At least 2–3 vertebral spaces should be treated both
cranial and caudal to the affected one. Very often, larger
times faster!) shortening of the recovery time after areas of the back will benefit from being included in the
hemilaminectomy in dogs who received LT after the treatment area, since it is not uncommon to find other
surgical procedure [368] : 3.5 vs. 14 days until return to reactive or tender segments. Treating the paravertebral
ambulation, in dogs with a similar baseline assess- muscles in a longitudinal direction feels more comfort-
ment, and independently of age, weight, and dura- able to the patient, but you can also spend an extra 1–2
tion of clinical signs at presentation. seconds in the intervertebral spaces (unless you feel the
• When surgery is not the best option, as in many fur/skin gets a bit too warm), aiming the beam perpen-
mild chronic IVDD cases, or is not even an option dicularly to the muscle or in a slightly lateral-to-medial
for some reason, LT can be a great tool to add to the direction.
multimodal conservative management. And maybe Use 5–20 J/cm . The values that reach the spinal cord
2
not just because of the anti-inflammatory and anal- and roots will be much lower, and will more likely have
gesic effects; in a retrospective double-blind clinical an anti-inflammatory and stimulating effect. In a study
study in people who underwent diskectomy, those with 200–300 g rats, only 6% of 810 nm light reached
patients who received LT in the weeks before the the spinal cord, located at 10 mm depth, using 0.53 W/
2 [171]
procedure had more mucopolysaccharides and cm . Again an important factor here is how fast we

Table 9.5 Texas Spinal Cord Injury Score (TSCIS) for dogs.

Gait
0 No voluntary movement seen when supported
1 Intact limb protraction with no ground clearance
2 Intact limb protraction with inconsistent ground clearance
3 Intact limb protraction with consistent ground clearance (>75%)
4 Ambulatory, consistent ground clearance with moderate paresis–ataxia (will fall occasionally)
5 Ambulatory, consistent ground clearance with mild paresis–ataxia (does not fall, even on slick surfaces)
6 Normal gait
Propioceptive positioning
0 Absent response
1 Delayed response
2 Normal response
Nociception
0 No deep nociception
1 Intact deep nociception, no superficial nociception
2 Nociception present

REDONDO PRINT (4-COL BLEED).indd 128 08/08/2019 09:48