Acupuncture for Treatment of Intervertebral Disc Disease
World Small Animal Veterinary Association World Congress Proceedings, 2009
Jean Guilherme Fernandes Joaquim, DVM, MSc, PhD
University of State of São Paulo, Acupuncture and Chronic Pain Service, Botucatu-SP, Brazil; Bioethicus Institute, Botucatu, SP, Brazil

The intervertebral disk disease affect most of the dogs of chondrodystrophic breeds, with high incidence between three and six years. Most of the lesions, 85%, occur between T11-T12 and L2-L3 and 50% happens between T12-T13 and T13-L1. In large breeds the disease is most observed at L1-L2. The main clinical sign are back pain, somatosensorial deficit, motor deficits in pelvic limb, genitourinary dysfunction, between others. Based on this, many levels of lesion maybe presents on IVDD and this result in different approach for treatment, based mostly on the vet clinical knowledge than in literature review. The AP technique consists on the insertion of needles at specific skin points and has showed efficiency on the treatment of IVDD in man and animals. It is also used to relief pain, normalize motor and sensorial function and urinary control although few studies controlled studies haven showed the efficacy of the treatment in dogs comparing the treatment with conventional treatment. The purpose of this prospective controlled study was to compare the effects of treatment of electroacupuncture, decompressive surgery after 48hs of the begging of the neurological signs and electroacupuncture associated with surgery for thoracolumbar IVDD in dogs. We hypothesized that EA might be effective in promote improvement of neurologic function and recover ambulation in animals with IVDD.

Still state that the results of using AP for IVDD go down proportionally to the severity of medullar lesion. Others authors also describe the effects of AP for IVDD grade I and II with an improvement rate of 90%. The AP studies also mention the necessity of using electro stimulation for IVDD of grade III or more mentioning a rate of improvement of 85% after 2-6 weeks of AP treatment isolated. For grade IV, the rate of improvement with AP only was 58% after 10 weeks of treatment. The studies also indicate that acupuncture in grade IV should be considered IF the surgery cannot be done in the first 48 hours of the beginning of the neurological symptoms or when the surgery was not successfully.

Hayashi on a study with 50 dogs comparing the use of clinical management and clinical management associated with EA found that the association results in quickly recovery and improvement of ambulation and deep pain sensibility. Macias observed that the prognosis of IVDD surgery might be dependant of type of disk disease, Hansen I or II, since protrusion shows a worse surgical response than animals with nuclear extrusion. This observation can be explained, according to the authors, to the fact that during the extrusion, the material in medullar channel can be reabsorbed or be located in a way that causes minimum compression to the spinal cord or one can also have an adaptation of the spinal cord to the compressive phenomena.

Another study, trying to explain the distal effects of acupoints stimulation found using magnetic resonance that when stimulating points such as LI4 and 11(large intestine), located at the first and second metacarpal bone and in the crease of humero-radio-ulnar joint, respectively, there is a segmental activation on the level of C2 and C3 cervical spinal cord. Yamamura showed another path of AP mechanism of action in the spinal cord, studying the behavior of IVDD with tomography in human, where they theorize the acupuncture effect on the increase, inhibition or diminution of immunological process due to nucleus pulposus extrusion explaining the improvement of IVDD due to AP treatment. The immunological approach of the disk extrusion is also corroborated by other authors and studies showing the participation of the lymphocytes, macrophages, metalloproteinase, interleukins and others on the spinal inflammatory site. In relationship to the surgery, the technique used in this study was the hemilaminectomy, which is according to the literature the most useful in case of compressive IVDD.

In a study where 25-38% of the animals have improved when the surgery was done at 12-24 hours after the beginning of the neuroclinical signs, 43% if surgery was done between 24-48 hours of the initial signs and 5-24% if surgical intervention was done after 48 hours of the beginning of the neuroclinical symptoms. The absence of deep pain sensibility can also influence the rate of recovery after surgery. A retrospective study mention that the improvement rate of ambulation after IVDD decompressive surgery was 89,5% for deep pain present animals and only 50% for animals with absence of deep pain emphasizing the importance of deep pain for post surgery prognosis. Another important information is that in a study of neurological evaluation of paraplegic animals, 42% of the animals that could ambulate, do not have deep pain sensibility although still walking.


1.  De Lahunta A. Veterinary neuroanatomy and clinical neurology. 2 ed. Philadelphia: Saunders, 1983. 471 p.

2.  Kiberger RM, Roos CJ, Lubbe AM. The radiological diagnosis of thoracolumbar disc disease in the dachshund. Vet Rad Ultras 1992; 33:255-61.

3.  Wheeler SJ, Sharp NJH. Thoracolumbar disc disease. In: Small animal spinal disorders. Diagnosis and Surgery. China: Elsevier-Mosby, 2005;121-160.

4.  Seim III HB. Cirurgia da espinha toracolombar. In: Fossum TW, Hedlund CS, Hulse DA, Johnson AL, Seim Iii HB, Willard MD, Carroll GL. Cirurgia de Pequenos Animais. São Paulo: Roca, 2002; 1216-1248.

5.  Longworth W, Mccarthy PW. A Review of research on acupuncture for the treatment of lumbar disk protrusions and associated neurological symptomatology. The J Altern Compl Med 1997; 3: 55-76.

6.  Still J. Acupuncture treatment of thoracolumbar disc disease: a study of 35 cases. Comp Anim Pract Acup 1988; 2:19-24.

7.  Chierichetti AL, Alvarenga J. Afecção degenerativa do disco intervertebral toracolombar: revisão. Clín Vet 1999;22:25-30.

8.  Mok JS, Won PS. Application of traditional acupuncture on canine intervertebral disc disease. J Vet Clin 2004;21:49-51.

9.  Hayashi AM, Matera JM, Pinto ACBCF. Evaluation of electroacupuncture treatment for thoracolumbar intervertebral disk disease in dogs. J Am Vet Med Ass 2007; 231:913-918.

10. Still J. Analgesic effects of acupuncture in thoracolumbar disc disease in dogs. J. Small Anim Pract 1989;30:298-301.

11. Janssens LAA. Acupuncture treatment for canine thoraco-lumbar disk protrusions / a review of 78 cases. Vet Med Small An Clin 1983;37:1580-1585.

12. Janssens LAA. Acupuncture for thoracolumbar and cervical disk disease. In: Schoen AM ed. Veterinary Acupuncture--Ancient Art to Modern Medicine. 2nd ed. St. Louis: Mosby, 2001;193-198.

13. Colter SB. Fenestration, decompression, or both? Vet Clin North Am Small Anim Pract 1978;8:379-383.

14. Toombs JP. Cervical intervertebral disk disease in dogs. Contin Educ Pract Vet 1992;14:1477-1489.

15. Digón N. Fisioterapia e reabilitação em neurologia. In: Pellegrino F, Suraniti A, Garibaldi L. eds. Síndromes Neurológicas em Cães e Gatos. São Caetano do Sul: Interbook Com. Imp. Livros Ltda., 2003;334-343.

16. Chen YX, Kong KM, Wang WD, et al. Functional MR imaging of the spinal cord in cervical spinal cord injury patients by acupuncture at LI 4 (Hegu) and LI 11(Quchi). Conf Proc IEEE Eng Med Biol Soc 2007;91:2007-3388.

17. Yamamura Y, Laredo FJ, Novo NF, et al. Tratamento da Hérnia do disco intervertebral lombar pela acupuntura. Análise de 41 pacientes. Rev Paul Acup 1996;2:13-23.

18. Martin MD, Boxell CM, Malone DG. Pathophysiology of lumbar disc degeneration: A review of the literature. Available at: Accessed Jan 24, 2008.

19. Dhupa S, Glickman N, Waters DJ. Reoperative neurosurgery in dogs with thoracolumbar disc disease. Vet Surg 1999;28:421-428.

20. Jerram RM, Dewey CW. Acute thoracolumbar disk extrusion in dogs--Part II. Comp Cont Ed Pract 1999; 21:1037-1047.

21. Gambardella PC. Dorsal decompressive laminectomy for treatment of thoracolumbar disk disease in dogs: a retrospective study of 98 cases. Vet Surg 1980;9:24-26.

22. Olby NJ, Harris T, Munana KR, et al. Long term functional outcome of dogs with severe spinal cord injuries. J Am Vet Med Assoc 2003;222:762-769.

23. Olby N, Halling KB, Glick TR. Reabilitação neurológica. In: Levine D, Millis DL, Little DJM, et al. Reabilitação e Fisioterapia na Prática de Pequenos Animais. 1st ed. São Paulo: Editora Roca Ltda., 2008;157-180.

24. Joaquim JGF, Luna SPL, Torelli S, Angeli AL, Gama ED. Study of 43 dogs with neurological disease: A western and eastern view of the neurological pattern of diseases In: 29th Annual International Congress on Veterinary Acupuncture, 2003, Santos. Proceedings...Santos: 29th Annual International Congress on Veterinary Acupuncture. , 2003. p.289-297

25. Angeli AL, Joaquim J GF, Gama, ED, Luna SPL. Outcome of 119 dogs and cats treated at the acupuncture unit of the Faculty of Veterinary Medicine and Animal Science of the University of São Paulo State, Botucatu city, Brazil. Brazilian Journal of Veterinary Research and Animal Science, São Paulo, v. 42, n. 1, p. 68-74, 2005.


Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Jean Guilherme Fernandes Joaquim, DVM, MSc, PhD
University of State of São Paulo
Acupuncture and Chronic Pain Service
Botucatu , SP , Brazil

MAIN : Alternative Medicine : Intervertebral Disc Disease
Powered By VIN