scholarly journals Intradural Disc Extrusion in a Dog

2020 ◽  
Vol 48 ◽  
Author(s):  
Angel Ripplinger ◽  
Graciane Aiello ◽  
Mathias Reginatto Wrzesinski ◽  
Marcelo Luís Schwab ◽  
Júlia Da Silva Rauber ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Conservative Treatment ◽  
Intervertebral Disc ◽  
Spinal Canal ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Material ◽  
Spinal Cord Dysfunction ◽  
Intradural Space ◽  
Disc Extrusion

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.

scholarly journals Intervertebral Disc Extrusion between T8 and T9 in a Dachshund

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
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Canal ◽  
Clinical Signs ◽  
Type I ◽  
Thoracic Region ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Rib Head ◽  
Disc Extrusion

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.

scholarly journals Fibrocartilaginous Embolism Associated with the Extrusion of the Intervertebral Disc in a Dog

2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Rafael Oliveira Chaves ◽  
Bruna Copat ◽  
Diego Vilibaldo Beckmann ◽  
João Pedro Scusssel Feranti ◽  
Marília Teresa De Oliveira ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Cord Compression ◽  
Spinal Reflexes ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Hind Limbs ◽  
Fibrocartilaginous Embolism ◽  
Disc Extrusion

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.

scholarly journals Conservative treatment of cervical intervertebral disc disease in a dog with the use of a cervical collar: case report

2020 ◽  
Vol 13 (3) ◽  
pp. 57
Author(s):  
G. F. Pessine ◽  
D. Farias Junior
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Intervertebral Disc ◽  
Conservative Management ◽  
Clinical Signs ◽  
Clinical State ◽  
Intervertebral Disc Disease ◽  
Disc Disease

Intervertebral Disc Disease (IVDD) is the main  spinal cord disease in dogs, especially  of chondrodisthrophic breeds, and it’s  characterized  by structural degeneration of discs, following protrusion or extrusion of debris to the medullar canal, compression and variable degrees of pain, paresis and ataxia. Surgical  descompressive intervention   coupled with disc fenestration are the treatment of choice as it promotes faster recovery with higher succes rates, not withou important morbidity and mortality. The conservative management is considered when the pacient has mild clinical signs, doesn’t have severe medullar compression or contusion lesions on imaging tests, as well as when there are restrictions associated with the clinical state of the pacient or the higher costs of surgical treatment.

Residual herniated disc material following hemilaminectomy in chondrodystrophic dogs with thoracolumbar intervertebral disc disease

2012 ◽  
Vol 25 (02) ◽  
pp. 109-115 ◽  
Author(s):  
M. Thomas ◽  
J. M. Weh ◽  
J. Bleedorn ◽  
K. Wells ◽  
W. J. Roach
Keyword(s):  
Intervertebral Disc ◽  
Herniated Disc ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Vertebral Canal ◽  
Telephone Interviews ◽  
Disc Material ◽  
Long Term Follow Up

SummaryObjective: To evaluate the presence of residual disc material within the vertebral canal following hemilaminectomy in chondrodystrophic dogs with thoracolumbar intervertebral disc disease.Methods: Forty dogs were treated by hemilaminectomy. Computed tomography was performed preoperatively and immediately postoperatively. The vertebral canal height, width, area, and herniated disc material area were measured. Maximum filling percentage (MFP), residual disc percentage (RDP), maximum residual filling percentage (MRFP), and residual filling percentage (RFP) were calculated. Clinical outcome was determined by telephone interviews.Results: Residual disc material was present in 100% of the dogs. Mean MFP = 55.4% (range 25.9–82.3%; median 56.9%). Mean RDP = 50.3% (range 2.6–155.8%; median 47.9%). Mean MRFP = 30.8% (range 4.9–60%; median 30.1%). Mean RFP = 19.8% (range 4.8–45%; median 19.0%). All dogs were ambulatory with voluntary urination at the long-term follow-up (range: 88–735 days).Clinical significance: Residual disc was present in all dogs following hemilaminectomy for intervertebral disc disease. Residual disc was not associated with failure to achieve functional recovery in these cases.

Chymopapain treatment of intervertebral disc disease

1975 ◽  
Vol 42 (4) ◽  
pp. 374-383 ◽  
Author(s):  
Clark Watts ◽  
Robert Knighton ◽  
George Roulhac
Keyword(s):  
Intervertebral Disc ◽  
Proteolytic Enzyme ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Space ◽  
Content Type ◽  
Disc Material ◽  
Capillary Endothelial Cells ◽  
Fine Print ◽  
Rapid Conversion

✓ In the first of a two-part study, the authors review the known biochemical, pharmacological, toxicological, and experimental data concerning chymopapain and the intervertebral disc. They describe the action of this proteolytic enzyme, which apparently disrupts the protein mucopolysaccharide component of disc material, most marked in the nucleus pulposus. A rapid conversion to collagen causes a loss of disc space height; toxicity appears to result from alteration of bonding between capillary endothelial cells that in turn produces hemorrhage. Part 2 reviews significant reported results and complications of clinical chemonucleolysis.

Randomized, Blinded, Placebo-Controlled Clinical Trial of N-Acetylcysteine in Dogs With Spinal Cord Trauma From Acute Intervertebral Disc Disease

Spine ◽  
2008 ◽  
Vol 33 (13) ◽  
pp. 1397-1402 ◽  
Author(s):  
Wendy I. Baltzer ◽  
Maureen A. McMichael ◽  
Giselle L. Hosgood ◽  
Sharon C. Kerwin ◽  
Jonathan M. Levine ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Spinal Cord ◽  
Intervertebral Disc ◽  
Controlled Clinical Trial ◽  
Spinal Cord Trauma ◽  
Intervertebral Disc Disease ◽  
Disc Disease

scholarly journals Prevalence and breed predisposition for thoracolumbar intervertebral disc disease in cats

2016 ◽  
Vol 19 (4) ◽  
pp. 419-423 ◽  
Author(s):  
Steven De Decker ◽  
Anne-Sophie Warner ◽  
Holger A Volk
Keyword(s):  
Intervertebral Disc ◽  
General Hospital ◽  
Clinical Signs ◽  
Neurological Deficits ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Protrusion ◽  
Uncommon Condition ◽  
Hospital Population ◽  
Disc Extrusion

Objectives The objective was to evaluate the prevalence and possible breed predilections for thoracolumbar intervertebral disc disease (IVDD) in cats. Methods Medical records and imaging studies of cats diagnosed with thoracolumbar IVDD between January 2008 and August 2014 were retrospectively reviewed and compared with the general hospital population. The association between type of IVDD (ie, intervertebral disc extrusion [IVDE] or intervertebral disc protrusion [IVDP]) and breed, age, sex, and duration and severity of clinical signs was also evaluated. Results Of 12,900 cats presented during the study period, 31 (0.24%) were diagnosed with IVDD, including 17 purebred and 14 non-purebred cats. Of all presented purebred cats, 0.52% were diagnosed with thoracolumbar IVDD. More specifically, 1.29% of all British Shorthairs and 1.83% of all presented Persians were diagnosed with IVDD. Compared with the general hospital population, purebred cats ( P = 0.0001), British Shorthairs ( P <0.0001) and Persians ( P = 0.0006) were significantly overrepresented with thoracolumbar IVDD. Affected purebred cats were younger than affected non-purebred cats ( P = 0.02). Of 31 cats with IVDD, 19 were diagnosed with IVDE and 12 with IVDP. Cats with IVDE had a significantly shorter duration of clinical signs ( P = 0.0002) and demonstrated more severe neurological deficits ( P = 0.04) than cats with IVDP. Conclusions and relevance Although thoracolumbar IVDD is an uncommon condition in cats, purebred cats, British Shorthairs and Persians, were overrepresented. It is currently unclear if this represents a true breed predisposition or a higher likelihood of owners of purebred cats seeking referral for advanced diagnostic imaging procedures.

scholarly journals Diagnostic Imaging in Intervertebral Disc Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Ronaldo C. da Costa ◽  
Steven De Decker ◽  
Melissa J. Lewis ◽  
Holger Volk ◽  
Keyword(s):  
Computed Tomography ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Intervertebral Disc Herniation ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Protrusion ◽  
Disc Extrusion

Imaging is integral in the diagnosis of canine intervertebral disc disease (IVDD) and in differentiating subtypes of intervertebral disc herniation (IVDH). These include intervertebral disc extrusion (IVDE), intervertebral disc protrusion (IVDP) and more recently recognized forms such as acute non-compressive nucleus pulposus extrusion (ANNPE), hydrated nucleus pulposus extrusion (HNPE), and intradural/intramedullary intervertebral disc extrusion (IIVDE). Many imaging techniques have been described in dogs with roles for survey radiographs, myelography, computed tomography (CT), and magnetic resonance imaging (MRI). Given how common IVDH is in dogs, a thorough understanding of the indications and limitations for each imaging modality to aid in diagnosis, treatment planning and prognosis is essential to successful case management. While radiographs can provide useful information, especially for identifying intervertebral disc degeneration or calcification, there are notable limitations. Myelography addresses some of the constraints of survey radiographs but has largely been supplanted by cross-sectional imaging. Computed tomography with or without myelography and MRI is currently utilized most widely and have become the focus of most contemporary studies on this subject. Novel advanced imaging applications are being explored in dogs but are not yet routinely performed in clinical patients. The following review will provide a comprehensive overview on common imaging modalities reported to aid in the diagnosis of IVDH including IVDE, IVDP, ANNPE, HNPE, and IIVDE. The review focuses primarily on canine IVDH due to its frequency and vast literature as opposed to feline IVDH.

scholarly journals Classification of Intervertebral Disc Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Joe Fenn ◽  
Natasha J. Olby ◽  
Keyword(s):  
Intervertebral Disc ◽  
Intervertebral Disc Degeneration ◽  
Clinical Findings ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Clinical Presentations ◽  
Disc Material ◽  
Definition Of ◽  
Current Systems

Intervertebral disc disease (IVDD) has been recognized in dogs since the 1800s, when the first descriptions of extruded disc material within the vertebral canal were published. In the intervening time our understanding of intervertebral disc pathology in dogs and cats has increased dramatically, with many variations of IVDD described. Whilst the volume of literature and collective understanding of IVDD has expanded, there has also been scope for confusion as the definition of intervertebral disc disease, with its myriad different manifestations, becomes more complicated. A large volume of literature has aimed to combine the use of histopathology, diagnostic imaging and clinical findings to better understand the various ways in which IVDD can be classified. Much of this research has focused on the classification of mechanisms of intervertebral disc degeneration, centering around the differences between, and overlaps in, IVDD in chondrodystrophic and non-chondrodystrophic dog breeds. However, with the increasing availability of advanced imaging modalities allowing more accurate antemortem diagnosis, the concept of IVDD has expanded to include other clinical presentations that may not fit into traditional models of classification of IVDD. This review aims to provide an up to date overview of both historical and current systems of IVDD classification, highlighting the important findings and controversies underpinning them.

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