Agreement between magnetic resonance imaging, myelography, and surgery for detecting recurrent, thoracolumbar intervertebral disc extrusion in dogs

Reynolds, Debbie; Brisson, Brigitte A.; Nykamp, Stephanie

doi:10.3415/vcot-12-05-0067

Cited by 8 publications

(6 citation statements)

References 44 publications

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“…Gelatin sponges can also be easily differentiated from residual disc material based on their sharply demarcated shape and hyperintensity on T2W images (120). MRI was also very accurate (100%) for identification of late recurrent disc extrusion either at the same or different site (mean interval between initial surgery and recurrence 404.5 days) in a study comparing it to myelography (122).…”

Section: Mri and Surgerymentioning

confidence: 99%

“…In all cases where planning differed, a significantly larger hemilaminectomy defect (a greater number of articular facets removed) was planned using MRI compared to CT (70). MRI is also a very useful modality to investigate patients in the post-operative period (105,(120)(121)(122). MR imaging can differentiate residual extruded nucleus from hemorrhage, based on signal intensity and gradient echo characteristics (101,120).…”

Section: Mri and Surgerymentioning

confidence: 99%

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Diagnostic Imaging in Intervertebral Disc Disease

et al. 2020

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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.

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Section: Mri and Surgerymentioning

confidence: 99%

Section: Mri and Surgerymentioning

confidence: 99%

Diagnostic Imaging in Intervertebral Disc Disease

et al. 2020

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“…Evaluation of the influence of vertebral malformations on IVDE was outside the scope of this study; However, we did not identify an IVDE at an IVD space directly adjacent to a vertebral malformation. Magnetic resonance imaging is the gold standard for the diagnosis of IVDE (6)(7)(8). Extradural degenerated extruded nucleus pulposus is typically defined as a hypointense mass within the epidural space in T1w and T2w images (18,19).…”

Section: Resultsmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) represents the gold standard diagnostic tool for IVDE (6)(7)(8). On MRI, compared to spinal cord parenchyma, extruded degenerated nucleus pulposus material usually appears as a hypointense mass within the epidural space on T1-weighted (T1w) and T2-weighted (T2w) images (8).…”

Section: Introductionmentioning

confidence: 99%

Clinical, magnetic resonance imaging, surgical features and comparison of surgically treated intervertebral disc extrusion in French bulldogs

Albertini,

Stabile,

Marsh

et al. 2023

Front. Vet. Sci.

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Intervertebral disc (IVD) extrusion (IVDE) is the most reported neurological condition in French bulldogs (FBD). The aim of this study was to retrospectively evaluate neurological grade, magnetic resonance imaging (MRI), surgical findings and short-term recovery in surgically treated FBD diagnosed with IVDE referred to a single institution between January 2020 and March 2022 and to compare cervical and thoracolumbar IVDE. Data was gathered from medical records and analysed via Fischer’s Exact-Test and Kruskal Wallis-tests. Statistical significance was assumed when p < 0.05. Thirty-nine FBD were diagnosed with IVDE. Cervical IVDE (C-IVDE) was diagnosed in 11/39 cases; the C3-C4 IVD space was the most commonly affected site (5/11). Thoracolumbar IVDE (TL-IVDE) was diagnosed in 28 cases; the L3-L4 IVD space was the most commonly affected site (7/28). At admission, C-IVDE was significantly associated with less severe neurological grade (grade 1–2) compared to TL-IVDE (grade 2–5) (p < 0.001). The extruded IVD material (EIVDM) was hypointense in T2w images in 11/11C-IVDE vs. 2/28TL-IVDE, and hypointense in T1w images in 10/11C-IVDE vs. 1/28TL-IVDE. The EIVDM was hyperintense in T2w images in 0/11C-IVDE vs. 26/28TL-IVDE and iso-to-hypointense in T1w images in 1/11C-IVDE vs. 27/28TL-IVDE (p < 0,001). The EIVDM extended over ≥2 IVD spaces in 0/11C-IVDE vs. 19/28TL-IVDE (p < 0,001). 10/11C-IVDE underwent single ventral slot, 1/11C-IVDE underwent unilateral cervical hemilaminectomy. All TL-IVDE underwent unilateral hemilaminectomy and 19/28TL-IVDE underwent unilateral hemilaminectomy over ≥2 IVD spaces (p < 0,001). Haemorrhagic EIVDM was noticed intraoperatively in 1/11C-IVDE vs. 28/28TL-IVDE (p < 0,001). Spinal cord compression was mild in 2/11C-IVDE and 3/28TL-IVDE; moderate in 9/11C-IVDE and 16/28TL-IVDE; severe in 0/11C-IVDE and 8/28TL-IVDE. There was no spinal cord compression in 1/28TL-IVDE with foraminal IVDE. There was no statistical difference between spinal cord compression and IVDE location (p = 0.112). The mean time to improvement was 1.1 day in C-IVDE (range 1–2 days). 90.1% of C-IVDE improved within the first 24 h. The mean time to improvement was 2.1 days in TL-IVDE (range from 1 day to 4 days). All dogs that did not improve (5/39) were grade 5 TL-IVDEs at presentation. In FBD, TL-IVDE tended to cause higher grade of neurological dysfunction, tended to result in compression of neural structures over multiple IVD spaces and required more extensive surgical treatment than C-IVDE.

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“…In contrast, in Hakozaki’s study, diagnoses were made via myelography, CT, or MRI, and the affected discs were subjectively identified based on spinal cord compression. The sensitivity of detecting spinal cord compression associated with IVDD differed among the three modalities [ 20 , 30 , 31 ]. Considering the differences in imaging modalities and definitions of the affected disc, the results may not be comparable between the two studies.…”

Section: Discussionmentioning

confidence: 99%

Outcomes in Dogs with Multiple Sites of Cervical Intervertebral Disc Disease Treated with Single Ventral Slot Decompression

Chang,

Huang,

Lua

et al. 2023

Veterinary Sciences

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In dogs with acute myelopathy but showing multiple sites of spinal compression from intervertebral disc disease (IVDD) on imaging, one approach is surgical decompression of the single acute disc extrusion while ignoring other previously extruded or protruded discs. However, little is known regarding the outcomes of this approach. This study described the outcomes and investigated prognostic factors in 40 dogs with multiple sites of cervical disc extrusion or protrusion on MRI who underwent ventral slot decompression for the single acute disc. The overall recovery rate was 97.5%. The median recovery time was seven days. The number of affected discs (including disc extrusion and protrusion) and the presence and number of the affected discs causing severe spinal compression did not influence the 30-day outcome. Compared with 23 dogs with single disc extrusion treated surgically, the recovery time and outcomes were similar between the two groups. The total number of affected discs was not associated with recovery time or outcomes. In conclusion, if an acute disc could be identified, ventral slot decompression targeting the single acute disc is a viable management approach for dogs with an acute presentation but diagnosed with multiple sites of spinal cord compression from IVDD.

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Agreement between magnetic resonance imaging, myelography, and surgery for detecting recurrent, thoracolumbar intervertebral disc extrusion in dogs

Abstract: Despite the limitations of MRI, there was greater agreement between observers using MRI for both the recurrent and first lesion.

Cited by 8 publications

References 44 publications

Diagnostic Imaging in Intervertebral Disc Disease

Diagnostic Imaging in Intervertebral Disc Disease

Clinical, magnetic resonance imaging, surgical features and comparison of surgically treated intervertebral disc extrusion in French bulldogs

Outcomes in Dogs with Multiple Sites of Cervical Intervertebral Disc Disease Treated with Single Ventral Slot Decompression

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