Partial lateral corpectomy for ventral extradural thoracic spinal cord compression in a cat

A 7-year-old, female spayed, domestic shorthair cat was presented for ambulatory paraparesis. No trauma history was reported. Myelography and subsequent computed tomography revealed multiple ventrally located extradural spinal cord compressive lesions possibly due to intervertebral disc disease. Compression at the level of Th3-Th4 intervertebral disc space was considered responsible for the paraparesis. The lesion was approached via a right-sided lateral partial corpectomy as described for dogs. Complete spinal decompression was achieved, as documented intraoperatively by visual inspection and palpation of the spinal canal. No surgery related complications were encountered and the cat improved gradually within 8 weeks after the procedure. At 1 year follow-up only a slight proprioceptive deficit in the right hind limb could be noted. This is the first report of partial lateral corpectomy in a cat and should encourage the use of this technique even in small patients.     

Modified lateral spinal decompression in 61 dogs with thoracolurnbar disc protrusion

A modified lateral spinal decompression technique was performed in 61 dogs with thoracolumbar disc protrusion. Myelography combined with plain radiography and neurological examination determined the side of greatest compression in 93 per cent of the dogs. Disc material was retrieved in 98 per cent of the cases. Of the 35 non-ambulatory dogs, 95 per cent regained the ability to walk. The recovery time was three weeks.     

Spinal-evoked potentials in dogs with acute compressive thoracolumbar spinal cord disease

Spinal evoked potentials (SpEP) were recorded on an electromyograph from electrodes placed percutaneously in the ligamentum flava at the lumbosacral junction and between the 10th and 11th thoracic vertebrae following tibial nerve stimulation in 31 anesthetized dogs with acute compressive spinal cord injuries. The neurologic status of each dog was determined by clinical examination before SpEP recordings, and the neurologic status was monitored for 2 months in dogs that had surgical or conservative treatment. Two months after spinal injury, the response to treatment (outcome) of each dog was evaluated and graded as favorable (ambulatory and urinary continent) or unfavorable (nonambulatory, urinary incontinent, or euthanatized with confirmation of myelomalacia). Onset latencies, conduction velocities, amplitudes and durations of the wave forms, and the ratio of conduction velocity to combined durations of the first positive (P1) and first negative (N1) waves (CV/DPN index) were determined and were compared with reference data from clinically normal (control) dogs. Single SpEP recordings were of value in determining the prognosis for recovery. Significant differences were not found in the L7-S1 recordings between the reference (control) and spinal injury groups. Analysis of data from the T10-11 recordings indicated significant differences between the reference and spinal injury groups and between the favorable and unfavorable outcome groups within the spinal injury group. A CV/DPN index was less than 30 in dogs with unfavorable outcomes and greater than 30 in dogs with favorable outcomes. Stepwise discriminant analysis of data from the spinal injury group predicted outcome correctly in all dogs.     

Computed tomographic evaluation of cervical vertebral canal and spinal cord morphometry in normal dogs

The height, width, and cross-sectional area of the vertebral canal and spinal cord along with the area ratio of spinal cord to vertebral canal in the cervical vertebra were evaluated in images obtained using computed tomography (CT). Measurements were taken at the cranial, middle, and caudal point of each cervical vertebra in eight clinically normal small breed dogs (two shih tzu, two miniature schnauzers, and four mixed breed), 10 beagles, and four German shepherds. CT myelography facilitated the delineation of the epidural space, subarachnoid space, and spinal cord except at the caudal portion of the 7th cervical vertebra. The spinal cord had a tendency to have a clear ventral border in the middle portion of the vertebral canal and lateral borders near both end plates. The height, width, and area of the vertebral canal and spinal cord in the cervical vertebra were increased as the size of dog increased. However, the ratio of the spinal cord area to vertebral canal area in the small dogs was higher than that of the larger dogs. Results of the present study could provide basic and quantitative information for CT evaluation of pathologic lesions in the cervical vertebra and spinal cord.     

Relationship between spinal biomechanics and pathological changes in the equine thoracolumbar spine

The relationship between spinal biomechanics and pathological changes occurring in functionally normal equine thoracolumbar spines was studied in 23 horses. Ventrolateral vertebral body osteophytes occurred in 36 per cent of the spines. The majority occurred between the 10th and 17th thoracic vertebrae with the largest being found between the 11th and 13th thoracic vertebrae, the region of the thoracic spine where the greatest amount of lateral bending and axial rotation occurs. Impingement of the dorsal spinous processes was detected in 86 per cent of the spines with most lesions occurring between the 13th and 18th thoracic vertebrae. The severity of occurrence of impingement did not appear to be related to regional spinal mobility. Degeneration of intervertebral discs was observed in three of four specimens that were sectioned sagittally. It occurred in the first thoracic and the lumbosacral intervertebral discs and appeared to be related to the increased dorsoventral mobility and the increased disc thickness of these joints. The characteristic distribution of fractures of the thoracolumbar spine is discussed with respect to the biomechanics of the spine.     

Thoracolumbar lateral corpectomy for treatment of chronic disk herniation: technique description and use in 15 dogs

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.     

Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001)

OBJECTIVE: To determine long-term (> 6 months) outcome of dogs with paraplegia and loss of hind limb deep pain perception (DPP) resulting from intervertebral disk herniation or trauma. DESIGN: Retrospective study. ANIMALS: 87 dogs. PROCEDURE: Outcome was determined as successful or unsuccessful. The association of neuroanatomic localization, breed, age, weight, sex, and (for dogs with intervertebral disk herniation) speed of onset of signs and duration of paraplegia prior to surgery with outcome was evaluated. Owners were contacted by telephone to identify long-term health problems. RESULTS: Nine of 17 dogs with traumatic injuries were treated, and 2 regained the ability to walk; none of the 17 dogs regained DPP. Sixty-four of 70 dogs with intervertebral disk herniation underwent surgery; 9 (14%) were euthanatized within 3 weeks after surgery (7 because of ascending myelomalacia), 37 (58%) regained DPP and the ability to walk, 7 (11%) regained the ability to walk without regaining DPP, and 11 (17%) remained paraplegic without DPP. Outcome was not associated with any of the factors evaluated, but speed of recovery of ambulation was significantly associated with body weight and age. Fifteen (41%) and 12 (32%) dogs that regained DPP had intermittent fecal and urinary incontinence, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the prognosis for paraplegic dogs without DPP because of trauma was guarded, while dogs with disk herniation had a better chance of recovering motor function. A third of the dogs that recovered motor function had intermittent incontinence. Persistent loss of DPP did not preclude recovery of motor function, but such dogs remained incontinent.     

Perianesthetic morbidity and mortality in dogs undergoing cervical and thoracolumbar spinal surgery

ObjectiveTo evaluate and compare perioperative morbidity and mortality in dogs undergoing cervical and thoracolumbar spinal surgery.Study designProspective case series.Animals157 dogs undergoing cervical or thoracolumbar spinal surgery.MethodsData were collected sequentially on canine cases presented from the Neurology Section of the North Carolina State University Veterinary Teaching Hospital for anesthesia and surgery for cervical spinal cord disease. Simultaneously, data were collected on all thoracolumbar spinal surgery cases during the same time period. Data included signalment, drugs administered, surgical approach, disease process, cardiac arrhythmias during anesthesia, and outcome.ResultsData were collected from 164 surgical events in 157 dogs. There were 52 cervical approaches; four dorsal and 48 ventral. All thoracolumbar surgeries were approached dorsolaterally. Four dogs 4/52 (7.6%) undergoing a cervical approach did not survive to discharge. Two dogs (2/8; 25%) underwent atlanto-axial (AA) stabilization and suffered cardiovascular arrest and two dogs (2/38; 5.2%) undergoing cervical ventral slot procedures were euthanized following anesthesia and surgery due to signs of aspiration pneumonia. All dogs undergoing thoracolumbar surgery survived until discharge (112/112). Mortality in dogs undergoing cervical spinal surgery was greater compared with dogs undergoing thoracolumbar spinal surgery (p = 0.009), however, in dogs undergoing decompressive disc surgery, intraoperative death rates were not different between dogs undergoing a cervical compared with thoracolumbar approaches (p = 0.32) nor was there a significant difference in overall mortality (p = 0.07).Conclusion and clinical relevanceOverall, dogs undergoing cervical spinal surgery were less likely to survive until discharge compared with dogs undergoing thoracolumbar spinal surgery. Mortality in dogs undergoing cervical intervertebral disc decompression surgery was no different than for dogs undergoing thoracolumbar intervertebral disc decompression surgery. However, dogs undergoing cervical intervertebral disc decompression surgery should be considered at risk for aspiration pneumonia.     

Fecal incontinence and spinal cord abnormalities in seven dogs

Seven dogs with fecal incontinence and abnormal gaits were evaluated. Fecal incontinence was characterized as defecation of normal stools without posturing. Duration of clinical signs prior to evaluation ranged from 5 months to 3 years. Five dogs had upper motor neuron (UMN) paraparesis, and 2 dogs had UMN tetraparesis. With magnetic resonance imaging, spinal cord abnormalities primarily involving the dorsal aspect of the spinal cord were identified in all dogs. Five dogs had focal abnormalities, and 2 dogs had diffuse abnormalities of the spinal cord. Of the dogs with focal spinal cord lesions, 4 had cystic spinal cord abnormalities and 1 had a meningioma. Surgery was performed on all dogs with focal lesions; 4 of the 5 dogs had resolution of fecal incontinence after surgery. Results in these dogs suggest that fecal incontinence can be associated with spinal cord abnormalities and, depending on the characteristics of the lesion, can resolve after surgical treatment of the abnormality.     

Intramedullary cavernous malformation of the spinal cord in two dogs

Intramedullary cavernous malformations (CVMs) of the spinal cord were diagnosed in 2 adult dogs that presented for paraparesis. An intramedullary spinal cord lesion was identified on a myelogram in the first dog, and expansion of the vertebral canal was evident on radiographs in the second. Extensive intraparenchymal hemorrhage was found on gross postmortem examination in both dogs, and a distinct lobulated intramedullary mass was evident in the second dog. Microscopically, both lesions were composed of dilated, thin-walled vascular channels with little-to-no intervening neural parenchyma. Both dogs had evidence of channel thrombosis along with perilesional hemorrhage and hemosiderin accumulation. The second dog had additional degenerative changes, including thickened fibrous channel walls with hyalinization, foci of mineralization, and occasional tongues of entrapped gliotic neuropil. CVMs appear to be an uncommon cause of both acute and chronic spinal cord disease in the dog.