Association between filum terminale internum length and pain in Cavalier King Charles spaniels with and without syringomyelia

Abstract

Background: Lumbar syringomyelia (SM), lumbosacral pain, and more caudal spinal cord termination are reported in Cavalier King Charles spaniels (CKCS). Data are lacking on the clinical relevance of alterations in their spinal cord terminal structures. Objectives: To compare spinal cord termination level and filum terminale internum length (FTIL) with presence of lumbar SM and clinical signs in CKCS. Animals: Forty-eight CKCS. Methods: In this prospective study, pain was quantified using owner and clinician assessments. Vertebral level of spinal cord and dural sac termination, presence of SM, and FTIL were determined from sagittal magnetic resonance imaging (MRI) sequences. Kappa and intraclass correlation (ICC) analyses determined interobserver reliability. The MRI findings were compared to owner and clinician-reported pain quantification. Results: Interobserver reliability was good for spinal cord and dural sac termination (kappa = 0.61 and 0.64, respectively) and excellent for FTIL (ICC: 92% agreement). The spinal cord terminated at 6th lumbar vertebra in 1, 7th lumbar vertebra in 31, and the sacrum in 15 dogs, and termination level was associated with lumbar SM (P = .002) but not clinical signs. Mean FTIL was 2.9 ± 1.08 mm; it was associated with owner-reported pain (P = .033) and spinal palpation scores (P = .023). Painful CKCS without SM had shorter FTIL compared to normal CKCS and painful CKCS with SM (P = .02). Conclusions: Painful CKCS without SM have decreased distance between the termination of the spinal cord and dural sac, suggesting a shorter FTIL. More caudal spinal cord termination is associated with development of lumbar SM.

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“…Orthopedic and neurological examination was performed in all dogs 25 , 26 . Median joint pain score was 5 (range 0–17), and spinal pain was 2 (range 0–8), which generated a total median pain score of 6 (range 1–19).…”

“…The examination was done in a quiet room and treats were given frequently. Spinal pain was graded during palpation at the cervical, thoracolumbar, and lumbosacral regions from 0 to 3 as follows: 0: Does not notice; 1: Epaxial muscle tensing on palpation, 2: Muscle contraction and flinching, crouching, 3: Cries out, jumps away, tries to bite 25 . Scores at each region were summed to give a total score of 0–12.…”