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Case histories of 105 dogs that were treated for cervical intervertebral disk disease (IVDD) were studied retrospectively. To compare with previous data, dogs were grouped by age, gender, and breed. Dogs were also grouped by clinical signs of disease, and by presence and location of radiologic change. The age range of cases of cervical IVDD was 1 to 13 years (mean, 6.3 years). Fifty-nine percent of dogs treated for cervical IVDD were females, but the proportion of diseased females was similar to females in total hospital admissions. Twenty-eight breeds of dogs were treated for cervical IVDD. Dachshunds and Beagles were significantly over represented (P less than or equal to 0.001). However, gender-breed interaction was not observed. Prevalence of radiologic evidence of disk disease was detected at the following levels of the vertebral column: C2-3, 29%; C3-4, 24%; C4-5, 21%; C5-6, 15%; C6-7, 9%; and C7-T1, 2%. Significant difference was not observed in prevalence of cervical IVDD affecting the first 4 disk spaces. However, prevalence of cervical IVDD at C7-T1 was significantly less than that involving the first 4 disk spaces (P less than 0.02), and the space at C6-7 was significantly less affected than were the first 3 spaces (P less than 0.08). Significant association was not evident between clinical signs (pain and neurologic deficits) and radiologic signs of IVDD, although neurologic deficits were more likely to be observed in association with radiologic signs than with signs of pain.  相似文献   

3.
O bjectives : To describe the clinical and magnetic resonance imaging features of cervical vertebral malformation-malarticulation in Bernese mountain dogs.
M ethods : Seven Bernese mountain dogs (four males and three females) were diagnosed with cervical vertebral malformation-malarticulation by magnetic resonance imaging. The following data were evaluated retrospectively: (1) abnormalities of the cervical vertebral column and spinal cord, (2) spinal cord compression, (3) intervertebral disc degeneration and herniation, (4) severity of clinical signs pretreatment and after treatment, (5) type of treatment and (6) outcome.
R esults : Spin echo T1-weighted and T2-weighted images disclosed multi-level, extradural compressive spinal cord lesions (ventral, dorsolateral or both) spanning from intervertebral disc spaces C3-4 to C6-7. In all seven dogs, T2-weighted images disclosed one or more intramedullary hyperintensities associated with extradural spinal cord compression. Surgery was performed in five dogs. Two dogs were managed medically. The prognosis for surgical or conservative management in Bernese mountain dogs was similar to cervical vertebral malformation-malarticulation in other breeds.
C linical S ignificance : Cervical vertebral malformation-malarticulation is an important differential diagnosis for young to middle-aged Bernese mountain dogs with a C1-5 or C6-T2 neuroanatomic localisation. Dorsolateral spinal cord compression associated with articular process hypertrophy was the most common feature of cervical vertebral malformation-malarticulation in the seven Bernese mountain dogs evaluated.  相似文献   

4.
OBJECTIVE: To describe a technique for thoracolumbar lateral corpectomy and to evaluate its use for treatment of chronic thoracolumbar disk disease in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Fifteen dogs with signs of chronic thoracolumbar disk herniation. METHODS: After a dorsal or lateral approach to the spine, a lateral slot was created in 2 adjacent vertebral bodies on either side of the herniated disk and extruded/protruded material was removed. Data collected included history, duration of clinical signs, presurgical assessment of neurologic status, postsurgical neurologic status, complications, and outcome. RESULTS: Ambulatory capacity was maintained or regained, and neurologic status improved by 1 grade (3 dogs), 2 grades (8), 3 grades (2), or 4 grades (2). Eleven dogs were considered free of disease. A seroma in 1 dog was the sole complication observed. CONCLUSIONS: Lateral corpectomy permits relatively easy removal of protruded-extruded disk material from within the vertebral canal in chronic disk disease without further iatrogenic injury to the spinal cord. CLINICAL RELEVANCE: Lateral corpectomy is an alternative to dorsal decompression for treatment of ventral and lateroventral thoracolumbar chronic disk disease in dogs.  相似文献   

5.
CASE DESCRIPTION: A 1-year-old female spayed Labrador Retriever was admitted for evaluation of a progressive gait disturbance characterized by tetraparesis and general proprioceptive ataxia in all limbs. CLINICAL FINDINGS: Neurologic examination suggested a dysfunction of the C6-T2 spinal cord segments, which was slightly worse on the right side. Discomfort was suspected upon lateral flexion of the neck. Two magnetic resonance imaging (MRI) examinations at a 3-week interval revealed an intramedullary fluid-filled cavitary lesion adjacent to C7, containing a blood clot. TREATMENT AND OUTCOME: Following unsuccessful initial conservative management, surgical marsupialization of the lesion was performed through a dorsal laminectomy, durotomy, and myelotomy at C6 and C7. Histologic evaluation including immunohistochemistry was diagnostic for a vascular anomaly. Initially, the dog was nonambulatory with tetraparesis and became tetraplegic after surgery; movement was regained 6 days later. Four weeks after the procedure, the dog was able to walk unassisted. One year after surgery, the dog was actively running and jumping, with mild residual ataxia in the pelvic limbs. CLINICAL RELEVANCE: The intramedullary vascular anomaly in this dog was successfully treated with a surgical marsupialization technique. The combination of MRI, histologic evaluation, and immunohistochemistry enabled lesion localization, evaluation of cavity content, and final diagnosis.  相似文献   

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Two dogs presented with acute tetraparesis, hypoventilation, and bradycardia with a second-degree atrioventricular heart block. Neurological examination localized both lesions to the cervical spine. Diagnostic imaging revealed a ventral extradural compression at the second to third cervical (C(2)-C(3)) region in one dog and at the third to fourth cervical (C(3)-C(4)) region in the other. Following surgical correction of the extruded disk, the hypoventilation and bradycardia resolved. Cervical disk extrusions are a common cause of acute tetraparesis in the dog. This report shows that respiratory and cardiac complications may occur concurrently. The authors recommend screening dogs with cervical myelopathies for respiratory and cardiac dysfunctions and treating appropriately. Prompt surgical intervention and supportive care can improve the prognosis.  相似文献   

7.
Objective— To describe the influence of fenestration at the disc herniation site on recurrence in thoracolumbar disc disease of chondrodystrophoid dogs.
Study Design— Prospective clinical study.
Animals— Chondrodystrophic dogs (n=19).
Methods— Dogs were divided into 2 groups: group 1 (9 dogs) had thoracolumbar disc extrusion (Hansen type I) treated by hemilaminectomy and concomitant fenestration of the affected intervertebral disc and group 2 (10 dogs) had hemilaminectomy without fenestration. All dogs had 3 magnetic resonance imaging (MRI) examinations: preoperatively, immediately postoperatively to assess removal of herniated disc material, and again 6 weeks after surgery.
Results— There were 13 male and 6 female dogs; mean age, 7.1 years. Thoracolumbar disc herniation was confirmed with MRI. Immediate post surgical MRI revealed that the herniated disc removal was complete in all but 1 dog and that fenestration did not lead to complete removal of nucleus pulposus within the intervertebral disc space. On the 3rd MRI examination, none of the group 1 dogs had further disc material herniation at the fenestrated site. Six of the 10 group 2 dogs had a recurrence of herniation leading to clinical signs in 3 dogs (pain in 2 dogs, paresis in 1 dog).
Conclusion— In thoracolumbar disc herniation, fenestration of the affected intervertebral disc space prevents further extrusion of disc material.
Clinical Relevance— Fenestration reduces the risk of early recurrence of disc herniation and associated postoperative complications.  相似文献   

8.
Objective— To determine the success of medical management of presumptive cervical disk herniation in dogs and variables associated with treatment outcome. Design— Retrospective case series. Animals— Dogs (n=88) with presumptive cervical disk herniation. Methods— Dogs with presumptive cervical and thoracolumbar disk herniation were identified from medical records at 2 clinics and clients were mailed a questionnaire related to the success of therapy, clinical recurrence of signs, and quality of life (QOL) as interpreted by the owner. Signalment, duration and degree of neurologic dysfunction, and medication administration were determined from medical records. Results— Ninety‐seven percent of dogs (84/87) with complete information were described as ambulatory at initial evaluation. Successful treatment was reported for 48.9% of dogs with 33% having recurrence of clinical signs and 18.1% having therapeutic failure. Bivariable logistic regression showed that non‐steroidal anti‐inflammatory drug (NSAID) administration was associated with success (P=.035; odds ratio [OR]=2.52). Duration of cage rest and glucocorticoid administration were not significantly associated with success or QOL. Dogs with less‐severe neurologic dysfunction were more likely to have a successful outcome (OR=2.56), but this association was not significant (P=.051). Conclusions— Medical management can lead to an acceptable outcome in many dogs with presumptive cervical disk herniation. Based on these data, NSAIDs should be considered as part of the therapeutic regimen. Cage rest duration and glucocorticoid administration do not appear to benefit these dogs, but this should be interpreted cautiously because of the retrospective data collection and use of client self‐administered questionnaire follow‐up. Clinical Relevance— These results provide insight into the success of medical management for presumptive cervical disk herniation in dogs and may allow for refinement of treatment protocols.  相似文献   

9.
Objectives— (1) To assess spinal cord blood flow (SCBF) during surgical treatment of disk extrusion in dogs and (2) to investigate associations between SCBF, clinical signs, presurgical MRI images, and 24-hour surgical outcome.
Study Design— Cohort study.
Animals— Chondrodystrophic dogs with thoracolumbar disk extrusion (n=12).
Methods— Diagnosis was based on clinical signs and MRI findings, and confirmed at surgery. Regional SCBF was measured intraoperatively by laser-Doppler flowmetry before, immediately after surgical spinal cord decompression, and after 15 minutes of lavaging the lesion. Care was taken to ensure a standardized surgical procedure to minimize factors that could influence measurement readings.
Results— A significant increase in intraoperative SCBF was found in all dogs (Wilcoxon's signed-rank test; P =.05) immediately after spinal cord decompression and after 15 minutes. Changes in SCBF were not associated with duration of clinical signs; initial or 24-hour neurologic status; or degree of spinal cord compression assessed by MRI.
Conclusion— SCBF increases immediately after spinal cord decompression in dogs with disk herniation; however, increased SCBF was not associated with a diminished 24-hour neurologic status.
Clinical Relevance— An increase in SCBF does not appear to be either associated with the degree of spinal cord compression or of a magnitude sufficient to outweigh the benefit of surgical decompression by resulting in clinically relevant changes in 24-hour outcome.  相似文献   

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OBJECTIVE: To describe an intraoperative ultrasound imaging technique during dorsal laminectomy in 2 dogs with caudal cervical vertebral instability and malformation (CCVIM, "Wobbler syndrome"). STUDY DESIGN: Clinical case report. SAMPLE POPULATION: Two dogs with CCVIM. RESULTS: On neurologic examination there was tetraparesis with upper motor neuron signs in the thoracic limbs and lower motor neuron signs in the pelvic limbs in dog 1, and hyperreflexia of the rear limbs, normoreflexia of the right front limb, and hyporeflexia of the left front limb of dog 2. Both dogs had signs of marked cervical pain and radiographic signs of cervical spinal cord compression. Intraoperative ultrasonography of the spinal cord revealed protruding intervertebral disc at C5-6 (dog 1) and C6-7 (dog 2), and the parallel borders of the spinal cord and central canal after decompression. Continuous dorsal laminectomy (CDL) resulted in improvement over 16 months (dog 1) and 20 months (dog 2). CONCLUSIONS: Intraoperative ultrasonographic imaging of the cervical spinal cord after CDL was helpful in determining adequate decompression (postlaminectomy) of the spinal cord in relation to the ventral and lateral compressive component(s) and to image the protruding intervertebral disc. CLINICAL RELEVANCE: Intraoperative ultrasonography can be used to provide valuable information on the spinal cord and surrounding soft tissues for the neurosurgeon.  相似文献   

12.
OBJECTIVE: To determine the effect that ventral intervertebral disk fenestration has on the sagittal range of motion about the C5-C6 intervertebral space. STUDY DESIGN: A repeated measures in vitro mechanical study of spinal range of motion under controlled loading conditions before and after fenestration. SAMPLE POPULATION: A total of 10 canine cervical vertebral specimens (C4-C7) collected from clinically normal animals within 12 hours of euthanasia. METHODS: Specimens were loaded as cantilever beams fixed at C7. Weights (1 to 5 kg) were progressively applied to C4 to produce flexion or extension in the sagittal plane. Radiographs were taken at each load, 3 times before and 3 times after fenestration of the C5-C6 disk. The positions of radiodense markers embedded in the vertebrae were used to calculate flexion and extension angles and range of motion. RESULTS: Range of motion (difference between flexion and extension) and flexion and extension angles (individually) significantly increased after fenestration (P < .0001). CONCLUSION: Ventral fenestration produces sagittal instability of the C5-C6 disk space. CLINICAL RELEVANCE: In surgical fusion of caudal cervical intervertebral spaces in dogs, radiographically normal disks adjacent to the affected space are often fenestrated to facilitate distraction before surgical stabilization. This study shows that ventral fenestration produces instability of a caudal cervical intervertebral space in the model used. Such instability may contribute to the development of the secondary instability ("domino lesions") seen in some surgically treated dogs.  相似文献   

13.
OBJECTIVE: To determine complications and neurologic outcomes associated with dexamethasone administration to dogs with surgically treated thoracolumbar intervertebral disk herniation, compared with dogs not receiving dexamethasone. DESIGN: Retrospective case series. ANIMALS: 161 dogs with surgically confirmed thoracolumbar disk herniation. PROCEDURES: Medical records from 2 hospitals were used to identify dogs that had received dexamethasone < 48 hours prior to admission (dexamethasone group dogs), dogs that received glucocorticoids other than dexamethasone < 48 hours prior to admission (other-glucocorticoid group dogs), and dogs that received no glucocorticoids (nontreatment group dogs). Signalment, neurologic injury grade, laboratory data, and complications were extracted from medical records. RESULTS: Dexamethasone group dogs were 3.4 times as likely to have a complication, compared with other-glucocorticoid or nontreatment group dogs. Dexamethasone group dogs were 11.4 times as likely to have a urinary tract infection and 3.5 times as likely to have diarrhea, compared with other-glucocorticoid or nontreatment group dogs. No differences in neurologic function at discharge or recheck evaluation were detected among groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that treatment with dexamethasone before surgery is associated with more adverse effects, compared with treatment with glucocorticoids other than dexamethasone or no treatment with glucocorticoids, in dogs with thoracolumbar intervertebral disk herniation. In this study population, no difference in outcome was found among groups. These findings suggest that the value of dexamethasone administration before surgery in dogs with thoracolumbar disk herniation should be reconsidered.  相似文献   

14.
Intraoperative spinal ultrasonography was performed in cervical and lumbar spine of 2 and 5 normal dogs, respectively, following ventral slot technique or dorsal or hemilamenectomy. The dura was hyperechoic, while the parenchyma was hypoechoic. The subarachnoid space was anechoic. An echogenic line was present in the center of the spinal cord, as seen in human. Pulsation of the spinal cord was noted during M-mode imaging. Clinical findings of one dog with thoracolumbar disk herniation and one with thoracic vertebral fracture/subluxation confirmed the usefulness of intraoperative spinal ultrasonography for real time evaluation of spinal canal spatial abnormalities (mass lesion and degree of spinal cord compression on scanning planes) and spinal cord motion. Follow-up ultrasound examinations were possible from 6 days postoperatively.  相似文献   

15.
OBJECTIVE: To compare morphologic and morphometric features of the cervical vertebral column and spinal cord of Doberman Pinschers with and without clinical signs of cervical spondylomyelopathy (CSM; wobbler syndrome) detected via magnetic resonance imaging (MRI). ANIMALS: 16 clinically normal and 16 CSM-affected Doberman Pinschers. PROCEDURES: For each dog, MRI of the cervical vertebral column (in neutral and traction positions) was performed. Morphologically, MRI abnormalities were classified according to a spinal cord compression scale. Foraminal stenosis and intervertebral disk degeneration and protrusion were also recorded. Morphometric measurements of the vertebral canal and spinal cord were obtained in sagittal and transverse MRI planes. RESULTS: 4 of 16 clinically normal and 15 of 16 CSM-affected dogs had spinal cord compression. Twelve clinically normal and all CSM-affected dogs had disk degeneration. Foraminal stenosis was detected in 11 clinically normal and 14 CSM-affected dogs. Vertebral canal and spinal cord areas were consistently smaller in CSM-affected dogs, compared with clinically normal dogs. In neutral and traction positions, the intervertebral disks of CSM-affected dogs were wider than those of clinically normal dogs but the amount of disk distraction was similar between groups. CONCLUSIONS AND CLINICAL RELEVANCE: The incidence of intervertebral disk degeneration and foraminal stenosis in clinically normal Doberman Pinschers was high; cervical spinal cord compression may be present without concurrent clinical signs. A combination of static factors (ie, a relatively stenotic vertebral canal and wider intervertebral disks) distinguished CSM-affected dogs from clinically normal dogs and appears to be a key feature in the pathogenesis of CSM.  相似文献   

16.
Forty‐six dogs with either cervical (C1–C5 or C6–T2) or thoracolumbar (T3–L3) acute myelopathy underwent prospective conventional computed tomography (CT), angiographic CT, myelography, and CT myelography. Findings were confirmed at either surgery or necropsy. Seventy‐eight percent of lesions were extradural, 11% were extradural with an intramedullary abnormality, 7% were intramedullary, 2% were intradural–extramedullary, and 2% had nerve root compression without spinal cord compression. Intervertebral disc herniation was the most frequent abnormality regardless of signalment or neurolocalization. Twenty‐one of 23 Hansen type I disc extrusions but none of the Hansen type II disc protrusions were mineralized. Two chondrodystrophic dogs had acute myelopathy attributable to extradural hemorrhage and subarachnoid cyst. CT myelography had the highest interobserver agreement, was the most sensitive technique for identification of compression, demonstrating lesions in 8% of dogs interpreted as normal from myelography and enabling localization and lateralization in 8% of lesions incompletely localized on myelography due to concurrent spinal cord swelling. None of the imaging techniques evaluated permitted definitive diagnosis of spinal cord infarction or meningomyelitis but myelography and CT myelography did rule out a surgical lesion in those cases. While conventional CT was adequate for the diagnosis and localization of mineralized Hansen type I disc extrusions in chondrodystrophic breeds, if no lesion was identified, plegia was present due to concurrent extradural compression and spinal cord swelling, or the dog was nonchondrodystrophic, CT myelography was often necessary for correct diagnosis.  相似文献   

17.
In a retrospective study, common neurologic signs and results of treatment of cervical vertebral instabilities were reviewed. In 16 large dogs, vertebrae C5 and C6 were most frequently malformed and unstable. Treatment was conservative in 3 dogs, 1 dog was not treated, and 12 dogs were treated surgically (dorsal decompressive laminectomy and wire stabilization of the articular facets in most cases). The 3 conservative treatments and 8 of the 12 surgical treatments were considered beneficial.  相似文献   

18.
Magnetic resonance imaging (MRI) and computed tomography (CT) are commonly used to evaluate dogs with thoracolumbar myelopathy; however, relative diagnostic sensitivities for these two modalities have not been previously reported. The purpose of this prospective study was to compare diagnostic sensitivity and observer agreement for MRI and CT in a group of dogs with thoracolumbar myelopathy due to surgically confirmed intervertebral disk herniation (IVDH). All included dogs had magnetic resonance (MR) imaging followed by noncontrast CT using standardized protocols. Three experienced observers interpreted each imaging study independently without knowledge of clinical or surgical findings. The operating surgeon was aware of MR findings but not CT findings at the time surgical findings were recorded. Forty‐four dogs met the inclusion criteria. The sensitivity of CT was 88.6% (79.5%–94.2%) and of MR was 98.5% (95% confidence interval, 94.1%–99.7%) for diagnosis of intervertebral disk herniation. Specificity was not calculated, as all dogs had IVDH at surgery. Magnetic resonance imaging was more accurate than CT for identifying the site of intervertebral disk herniation‐associated spinal cord compression and differentiating disk extrusion vs. protrusion. Computed tomography was less accurate for lesion localization in per acute cases, as well as for chondrodystrophic, female, older and smaller (<7 kg) dogs. Inter‐rater agreement was good for lesion lateralization for both MR and CT (κ = 0.687, 95% CI = 0.552, 0.822, P = 0.002, and κ = 0.692, 95% CI = 0.542, 0.842, P = 0.003). Findings from the current study indicated that MR imaging was more sensitive and accurate than noncontrast CT for diagnosis and characterization of thoracolumbar myelopathy due to IVDH in dogs.  相似文献   

19.
Using an autogenous bone graft (obtained from the iliac crest), 4-mm cancellous bone screws, and polymethylmethacrylate, a distracted cervical spinal fusion technique was performed on 10 dogs with myelographic evidence of caudal cervical spondylomyelopathy. All dogs had evidence of dynamic soft tissue spinal cord compression, as indicated by flexion, extension, and traction myelographic views. Of the 10 dogs, 4 previously had undergone surgery by use of ventral slot or cervical disk fenestration techniques, and their neurologic status had deteriorated after the original surgery. Preoperative neurologic status of the 10 dogs included nonambulatory tetraparesis (n = 5), severe ataxia with conscious proprioceptive deficits (n = 2), and mild ambulatory ataxia with conscious proprioceptive deficits (n = 3). Five dogs had signs of various degrees of cervical pain. Clinical improvement was observed in 8 of 10 dogs--either improved neurologic status or elimination of cervical pain. Implant loosening developed in 3 dogs; 2 of them were euthanatized because of lack of neurologic improvement. Radiographic evidence of bony cervical fusion was observed during a 9- to 24-week period in 6 of the 8 surviving dogs. The distracted cervical fusion technique appears to be a valid surgical procedure to manage cervical spondylomyelopathy in those dogs in which the lesions are limited to one cervical intervertebral disk space.  相似文献   

20.
Treatment recommendations differ for dogs with intervertebral disk extrusion vs. intervertebral disk protrusion. The aim of this retrospective, cross‐sectional study was to determine whether clinical and magnetic resonance imaging (MRI) variables could be used to predict a diagnosis of thoracolumbar intervertebral disk extrusion or protrusion in dogs. Dogs were included if they were large breed dogs, had an MRI study of the thoracolumbar or lumbar vertebral column, had undergone spinal surgery, and had the type of intervertebral disk herniation (intervertebral disk extrusion or protrusion) clearly stated in surgical reports. A veterinary neurologist unaware of surgical findings reviewed MRI studies and recorded number, location, degree of degeneration and morphology of intervertebral disks, presence of nuclear clefts, disk space narrowing, extent, localization and lateralization of herniated disk material, degree of spinal cord compression, intraparenchymal intensity changes, spondylosis deformans, spinal cord swelling, spinal cord atrophy, vertebral endplate changes, and presence of extradural hemorrhage. Ninety‐five dogs were included in the sample. Multivariable statistical models indicated that longer duration of clinical signs (P = 0.01), midline instead of lateralized disk herniation (P = 0.007), and partial instead of complete disk degeneration (P = 0.01) were associated with a diagnosis of intervertebral disk protrusion. The presence of a single intervertebral herniation (P = 0.023) and dispersed intervertebral disk material not confined to the disk space (P = 0.06) made a diagnosis of intervertebral disk extrusion more likely. Findings from this study identified one clinical and four MRI variables that could potentially facilitate differentiating intervertebral disk extrusions from protrusions in dogs.  相似文献   

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