scholarly journals Consequences of intraoperative spinal cord manipulation in dogs with thoracolumbar intervertebral disc extrusion

2017 ◽  
Vol 69 (6) ◽  
pp. 1473-1479
Author(s):  
C.C. Diogo ◽  
E.A. Tudury ◽  
M.A. Bonelli ◽  
B.M. Araújo ◽  
M.L. de Figueiredo ◽  
...  

ABSTRACT The objective of the present study was to evaluate if extradural contact during hemilaminectomy would cause neurological deterioration in the early and/or late postoperative period in dogs with intervertebral disc extrusion. Nineteen dogs with thoracolumbar intervertebral disc extrusion underwent hemilaminectomy for spinal cord decompression and removal of extruded disc material. Meningeal contacts during surgery were quantified. Paraplegia (with nociception) and paraparesis were observed in 11/19 and 8/19 of dogs, respectively, before surgery. At the end of our study, only two (2/19) had paraplegia and one (1/19), paraparesis. There were more extradural contacts when extruded intervertebral disc material was at a ventrolateral position. Extradural contacts during surgery had no influence on neurological progression nor on time to recovery of motor function. Immediately (24 and 48 hours) after surgery, 13/19 dogs had the same neurological stage before surgery. At 7 and 90 days, 13/19 and 17/19 dogs, respectively, showed neurological improvement, compared with their preoperative stage. There was no influence of the number of extradural contacts on neurological recovery. These findings indicate that a careful inspection of the vertebral canal for removal of as much extruded disc material as possible does not cause neurologic deterioration.

2020 ◽  
Vol 48 ◽  
Author(s):  
Angel Ripplinger ◽  
Graciane Aiello ◽  
Mathias Reginatto Wrzesinski ◽  
Marcelo Luís Schwab ◽  
Júlia Da Silva Rauber ◽  
...  

Background: Intervertebral disc extrusion is an important cause of spinal cord dysfunction in dogs. Intradural localization of the extruded disc material is rare, and is generally associated with a traumatic event or with recurrence of disc extrusion at a previously affected site. We report the clinical presentation, diagnostic workup, and treatment of a dog with intradural intervertebral disc extrusion not preceded by a traumatic event.Case:  A 6-year-old male Dachshund was referred for neurological evaluation due to acute onset of hind-end paralysis preceded by claudication of the left hindlimb. The patient had been receiving conservative treatment to no effect. Neurological examination revealed asymmetric non-ambulatory paraparesis, absence of postural reactions and decreased muscle tone in both hindlimbs, a bilaterally diminished patellar reflex, and a hindlimb withdrawal reflex which was normal on the right and greatly diminished to absent on the left. The lower back was tender to epaxial palpation. Plain radiographs of the lumbar spine in the lateral projection showed calcified material within the spinal canal between the third and fourth lumbar vertebrae. Myelography was suggestively abnormal at the same level, with epidural leakage of contrast at L3-L4. Considering the clinical history, breed, age, neurological signs, and radiographic findings, intervertebral disc disease was suspected despite the inconclusive myelography findings. A dorsolateral lumbar hemilaminectomy was performed. Intraoperatively, the diagnosis was confirmed by visualization of a discolored spinal cord and absence of extradural material. The intradural space was accessed via durotomy. A firm, straw-yellow material was seen compressing the spinal cord and removed. Subsequent histopathological examination confirmed that this material consisted of extruded intervertebral disc contents. Postoperatively, the patient underwent physiotherapy and achieved a satisfactory recovery.Discussion: The most common cause of paraparesis in chondrodystrophic dog breeds is intervertebral disc extrusion. Intradural extrusion of the intervertebral disc is a rare phenomenon, often associated with vigorous exercise that causes laceration of the dura mater, allowing penetration of disc material into the intradural space. Although there were no classic signs of intervertebral disc disease on plain radiography, radiopaque material was visible within the spinal canal, which can occur in cases of calcified intervertebral disc extrusion. Myelography was inconclusive, but the decision was made to operate nevertheless, considering that the patient had not responded to conservative treatment and that surgicaltreatment is the most suitable approach for dogs with non-ambulatory paraparesis or paraplegia secondary to intervertebral disc extrusion. The surgical technique consisted of a hemilaminectomy and durotomy. Our diagnostic suspicion was confirmed intraoperatively, as in most cases of intradural disc extrusion in humans. Intradural disc extrusion is anuncommon phenomenon in dogs, and the diagnosis is usually only established intraoperatively. This unusual variant of intravertebral disc disease should be included in the differential diagnosis of spinal cord dysfunction in chondrodystrophic breeds, even in the absence of a history of trauma or preexisting intervertebral disc disease. Clinical treatment appears ineffective in these cases. Conversely, surgical treatment can yield good outcomes, and even functional recovery.


2020 ◽  
Vol 8 (1) ◽  
pp. e001042
Author(s):  
Koen Maurits Santifort

A 5-year-old 8. 2-kg Dachshund was presented with progressive paraparesis and ataxia of several weeks’ duration and signs of pain persisting despite conservative treatment consisting of (cage) rest and analgesic treatment with gabapentin (12.2-mg/kg three times a day) and meloxicam (0.1-mg/kg once a day). Neurological examination was consistent with a T3–L3 myelopathy. CT images showed a mineralised mass in the ventrolateral (right) vertebral canal with severe compression of the spinal cord, taking up >50% of the vertebral canal. An intervertebral disc extrusion (Hansen type I intervertebral disc herniation) with compressive myelopathy was (presumptively) diagnosed. A combination of a partial lateral corpectomy and pediculectomy ('mini-hemilaminectomy') was performed. This surgical approach was deemed best suited to provide adequate access and to remove as much material as possible without compromising the spinal cord. There were no intraoperative complications. Signs did not recur postsurgically, and 2 weeks postsurgery, neurological signs were resolved.


2019 ◽  
Vol 33 (01) ◽  
pp. 066-070
Author(s):  
Georgina Harris ◽  
Paul Freeman

Abstract Objective Intervertebral disc extrusion is a common disease affecting chondrodystrophic dogs. It has been reported that fenestration of thoracolumbar intervertebral discs reduces recurrence of disc extrusion and is associated with a low complication rate. One complication reported is iatrogenic introduction of disc material into the canal directly following fenestration. This study aimed to ascertain if, and at what frequency, additional disc material may be introduced into the vertebral canal by fenestration of the affected disc following decompressive surgery. Study Design Twenty-one dogs that underwent hemilaminectomy and disc fenestration for the treatment of thoracolumbar intervertebral disc extrusion had intraoperative assessment of the vertebral canal before and after fenestration. The spinal cord was first decompressed by hemilaminectomy and removal of all visible extruded disc material within the vertebral canal. Once no further material was visible, manual fenestration of the affected disc was performed. The vertebral canal was re-inspected, and the presence or absence of additional material was noted and included in the surgery report. Results Seven dogs showed the presence of new disc material in the vertebral canal post fenestration.This preliminary study shows that additional disc material can be forced into the vertebral canal by fenestration following decompressive surgery, with a frequency of 7/21. Conclusion This illustrates the importance of checking the vertebral canal after fenestration of an extruded intervertebral disc.


1996 ◽  
Vol 09 (04) ◽  
pp. 177-178 ◽  
Author(s):  
R. Selcer ◽  
W. H. Adams ◽  
W. B. Thomas ◽  
B. E. Wilkens

SummaryThree middle-aged (6-8 years), intact male Dachshunds were admitted to the University of Tennessee Veterinary Teaching Hospital (UTVTH) with acute onset of back pain and pelvic limb paralysis.Physical examination of dog #1 revealed hyperaesthesia of the thoracolumbar spine. Superficial pain sensation was absent in the pelvic limbs, while deep pain sensation was intact. The cutaneous trunci (panniculus) reflex was absent caudal to the thoraco-lumbar region. Reflexes to the pelvic limbs were exaggerated.A myelogram showed dorsal deviation of the ventral contrast column and attenuation of the ventral and dorsal contrast columns at the T9-T10 disc space. A hemilaminectomy was performed from T9 to T10, and mineralized disc material was retrieved from the vertebral canal at T9-T10. The T9- T10 to L3-L4 disc spaces were fenestrated. Two weeks after surgery, superficial and deep pain sensation of the rearlimbs were present, but paralysis persisted. The animal was euthanatised at the owners’ request. A postmortem examination was not performed.Dog #2 displayed absent superficial pain sensation, and intact deep pain sensation of the pelvic limbs. Hyperaesthesia of the thoracolumbar region and hyperreflexia of the rear limbs were noted. Examination of the cutaneous trunci reflex was not performed. A myelogram revealed ventral extradural compression of the spinal cord at T9- T10. A T9-T10 hemilaminectomy revealed a large amount of extruded disc material, which was removed. The Tll- T12 to L4-L5 intervertebral discs were fenestrated. Forty-eight hours postoperatively, the patient regained voluntary motor function, and recovery was uneventful.Neurologic examination of dog #3 revealed absence of deep pain sensation in the pelvic limbs; duration of which was not known. Spinal radiographs and myelography revealed ventral extradural spinal cord compression at T9-T10 (Fig.). A right-sided hemilaminectomy at T9-T10 revealed a large amount of calcified disc material, ventral to the spinal cord. The T11-T12 through Ll- L2 intervertebral discs were fenestrated. Sixty days postoperatively, paralysis persisted and the dog was euthanatised. No postmortem examination was performed.Herniation of the T9-T10 intervertebral disc was diagnosed in three Dachshunds with acute paraplegia. The clinical diagnosis and surgical management of T9-T10 disc herniation are similar to that in the more common sites of disc herniation.


2015 ◽  
Vol 10 (2) ◽  
pp. 237 ◽  
Author(s):  
Wu Chen ◽  
Dai-xun Jiang ◽  
Zhi-song Lu ◽  
Ge-bin Li ◽  
Sheng-yong Sun ◽  
...  

2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Rafael Oliveira Chaves ◽  
Bruna Copat ◽  
Diego Vilibaldo Beckmann ◽  
João Pedro Scusssel Feranti ◽  
Marília Teresa De Oliveira ◽  
...  

Background: Intervertebral disc disease is a usual neurological disorder in dogs, which the spinal cord is compressed by intervertebral disc extrusion or protrusion. Fibrocartilaginous embolic myelopathy isan acute infarction disease of spinal cord caused by fibrocartilaginous emboli histologically identical to the nucleus pulposus of intervertebral discs. The aim of this report is present two cases of fibrocartilaginous embolic myelopathy in dogs with intervertebral disc disease.Cases: Two dogs - dachshund breed - were referred to the Veterinary Medical Teaching Hospital of the UFSM. In the first case, the dog was three years old and the owner described complete inability to move the pelvic limbs. The neurological examination revealed paraplegia, postural reactions deficits, normal spinal reflexes and muscle tonus in the hind limbs, pain on palpation in T12-T11 region and loss of deep pain in hind limbs. In the other case, the dog was seven years old and the owner described partial inability to move four limbs. The neurological examination revealed non-ambulatory tetraparesis, postural reactions deficit, normal spinal reflexes in four limbs and pain on palpation in cervical spine. In both cases, the presumptive diagnosis was intervertebral disc disease and surgical treatment was indicated. The dog with thoracolumbar injury died during the anesthesia and the dog with cervical injury was euthanized, after decision of owner. During the necropsy was observed intervertebral disc extrusion between L1-L2 vertebrae in a dog and between C3-C4 vertebrae in the other case with cartilaginous fragments in the spinal canal. Histopathology revealed marked diffuse necrosis with multifocal hemorrhage and cartilaginous emboli.Discussion: Fibrocartilaginous embolic myelopathy is commonly reported in large and giant breed dogs, though also occur in small and medium-sized breeds of dogs. One hypothesis is the pulpous nucleus remains soft for a longer period in large breed dogs, empowering to infiltration in the spinal cord vessels. The intervertebral disc extrusion occurs predominantly in dogs with age between three and six years old, in the cervical, thoracolumbar (T11-L3) and lumbar regions. Chondroid or fibroid degeneration of the intervertebral disc is the most common cause of spinal cord compression in small animals. In chondrodistrophic breed dogs is frequently chondroid degeneration, which the nucleus pulposus moves into the spinal canal through rupture of the annulus fibrosus (extrusion or Hansen type I), causing acute spinal cord compression. The prevalence of fibrocartilaginous embolism in adult and old dogs increase the possibility of predisposing factors, facilitating the injection intravascular of nucleus pulposus material. One of the most accepted theories about the mechanism of fibrocartilaginous emboli into the vessels is due to increase of inside discal pressure and liberation of fibrocartilaginous emboli from nucleus pulposus into the vertebral artery for retrograde flow, reaching the spinal cord by blood flow. The simultaneous occurrence of intervertebral disc disease and the infarction of spinal cord in the proximate region accentuate the hypothesis that the etiology of fibrocartilaginous embolic myelopathy is mechanical into the vessels of the spinal cord.Keywords: neurology, spinal cord, intervertebral disc disease, dogs.


Spine ◽  
2001 ◽  
Vol 26 (9) ◽  
pp. 1090-1094 ◽  
Author(s):  
Masatsugu Miyaguchi ◽  
Hiroaki Nakamura ◽  
Miyuki Shakudo ◽  
Yuichi Inoue ◽  
Yoshiki Yamano

2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Gabriel Antonio Covino Diamante ◽  
Paulo Vinicius Tertuliano Marinho ◽  
Carolina Camargo Zani ◽  
Bruno Cesar Elias ◽  
Mônica Vicky Bahr Arias

Background: Intervertebral disc extrusion with consequent spinal compression or intervertebral disc disease (IVDD) is one of the most common causes of compressive myelopathy in dogs, and the thoracolumbar spine discs between T12 and L2 are most affected. Extrusions in cranial thoracic region are rare, and there is few cases in literature reporting this situations, this rarity is attributed to the presence of the intercapital ligament connecting the rib heads between T2 and T10, which strengthens this region both mechanically and anatomically. The aim of this article is report the clinical signs, diagnosis and treatment of a case of Type I Hansen IVDD between T8 and T9 in a Dachshund breed dog.Case: An 8-year-old Dachshund male dog was presented for investigation of pelvic limb incoordination and back pain, which started 10 days prior to the consultation. It had a history of a similar condition 3 months earlier that showed improvement after clinical treatment. On neurological examination was identified in both pelvic limbs proprioceptive ataxia, absence of proprioception, increased muscle tone, presence of interdigital reflex and increased patellar reflex. Cutaneous trunci reflex was absent below T11 on the left side, and pain was noted upon palpation of T7 through the T12 vertebrae. A grade II asymmetric thoracolumbar lesion with hyperesthesia was diagnosed. On suspicion of IVDD, cerebrospinal fluid (CSF) collection and CT scan analysis of the thoracolumbar region were performed. CT scan showed the presence of hyperattenuating and mineralized material, 1 cm long, on the floor of the spinal canal, mainly on the left side, occupying 80% of the diameter of the spinal canal between T8 and T9. The patient was then submitted to decompression surgery through hemilaminectomy and showed a good recovery. As the occurrence of disc extrusion in cranial thoracic region of chondrodystrophic breeds is rare, we report the clinical signs, diagnosis and treatment of a case of Type I Hansen intervertebral disc disease (IVDD) between T8 and T9 in a Dachshund breed dog.Discussion: All spinal discs can undergo a process of degeneration causing IVDD, in which the cervical and thoracolumbar regions are the most affected due to reasons not yet fully understood, however spinal cord compression between the T1 and T9 vertebrae is very rare, probably due to the strengthening provided by the intercapital ligament to the posterior annulus fibrosus. Disc extrusion in unusual locations in chondrodystrophic breeds is mainly reported as extrusion between vertebrae T1 and T2, and T9 and T10, with some cases was attributed to an anatomical abnormality of the intercapital ligament. The evaluation of intervertebral discs of the German shepherd breed dogs using MRI showed disc degeneration processes in thoracic vertebras. Disc extrusions often result in more severe clinical signs than protrusions, and occur acutely or subacutely, which was different from the case described here, maybe because the presence of the intercapital ligament permitted gradual extrusion allowing the spinal cord to adapt to the compression. Despite surgical access to this region being described as more complex due to the presence and proximity of the rib head to the vertebral body and the possibility of injuring the intercostal muscles causing pneumothorax, the hemilaminectomy and rib head excision at T9 could be performed without any complications. Thus, although unusual, the cranial thoracic region should not be overlooked as a possible site of occurrence of IVDD, since the diagnosis, treatment and prognosis are similar to those in patients with extrusions in the most common sites.Keywords: intervertebral disc degeneration, dogs, paresis, ataxia.


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