Degenerative lumbosacral stenosis (DLSS) is characterised by intervertebral disc degeneration, with secondary bony and soft-tissue changes leading to compression of the cauda equina. Large-breed, active and working dogs are the most commonly affected by DLSS. Specific manipulative tests allow the clinician to form a high suspicion of DLSS, and initiate investigation. Changes seen using conventional radiography are unreliable, and although contrast radiography represents an improvement, advanced imaging is accepted as the diagnostic method of choice. Treatment involves decompression and/or stabilisation procedures in working dogs, although conservative management may be acceptable in pet dogs with mild signs. Prognosis for return to work is only fair, and there is a high rate of recurrence following conventional surgery. Stabilisation procedures are associated with the potential for failure of the implant, and their use has not gained universal acceptance. A new surgical procedure, dorsolateral foramenotomy, offers a potential advance in the management of DLSS. everal aspects of the pathogenesis, heritability and optimal treatment approach remain uncertain.
Positioning the LS junction in full extension decreases the volume of the lumbosacral IVF. This dynamic narrowing was more pronounced in GSDs with signs of DLSS than in GSDs not overtly affected by DLSS.
The small amounts of sacroiliac joint motion detected in this study may buffer high-frequency vibrations during movement of dogs. Differences detected between breeds may be associated with the predisposition of German Shepherd Dogs to develop lumbosacral region signs of pain, although the biological importance of this finding was not determined. Future studies are warranted to compare sacroiliac joint variables between German Shepherd Dogs with and without lumbosacral region signs of pain.
An elongated sacral lamina has been described as one of the contributing factors for dogs with cauda equina syndrome due to degenerative lumbosacral stenosis (DLSS); however, published evidence is lacking on the accuracy of radiographic screening for the presence of this lesion. Objectives of this prospective, cross-sectional cadaver study were to describe the accuracy and repeatability of detection of the cranial sacral lamina margin on plain lateral radiographs of the lumbosacral junction in dogs. Twenty-five medium and large breed canine cadavers were radiographed before and after placement of a radiopaque hook in the cranial margin of the sacral lamina. Three independent evaluators placed digital markers at the perceived margin on preinterventional radiographs. The distance from perceived location to the true location on postinterventional radiographs was recorded for each dog and observer. A discordance threshold (distance between perceived and actual margin) of 1.5 mm was subjectively defined as clinically relevant. The three evaluators demonstrated good repeatability, although the accuracy for margin detection was only fair (mean discordance 1.7 mm). Evaluators demonstrated greater accuracy in identifying the landmark in juveniles (1.4 mm) vs. adults (1.8 mm; P < 0.01). Results of this study indicated that observer repeatability is good and accuracy is fair for correctly identifying the radiographic cranial margin of the sacral lamina in dogs. This should be taken into consideration when interpreting elongation of the sacral lamina in radiographs of dogs with suspected DLSS, especially adults.
Radiographic evidence of healing of the xenoimplanted portion of the TTA osteotomy was equivalent to results with ACBG. Healing of the proximal osteotomy site (above the cage) was improved when ACBG was used as the graft.
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