Differences in Epidural Pathology between Cervical and Thoracolumbar Intervertebral Disk Extrusions in Dogs

Züger, Laura; Fadda, Angela; Oevermann, Anna; Forterre, Franck; Vandevelde, M.; Henke, Diana

doi:10.1111/jvim.14887

Cited by 14 publications

(21 citation statements)

References 36 publications

(120 reference statements)

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“…Although no histopathological examination was performed to prove that the compressive material seen on MRI was degenerated disc material, it had the same appearance on MRI as cervical HNPE: midventral extradural spinal cord compression because of material with the characteristic “seagull”‐like shape and hyperintense appearance in comparison to spinal cord parenchyma in T2w and fat suppression short tau inversion recovery sequences (STIR; Figure C‐cc). Another study found significant less mineralization of extruded disc material in the cervical than in the thoracolumbar spinal column. The authors proposed that variances in biomechanical, biochemical, and metabolic aspects of the intervertebral discs at different locations were responsible for different amounts of degeneration in the cervical and thoracolumbar intervertebral discs .…”

Section: Discussionmentioning

confidence: 93%

“…Another study found significant less mineralization of extruded disc material in the cervical than in the thoracolumbar spinal column. The authors proposed that variances in biomechanical, biochemical, and metabolic aspects of the intervertebral discs at different locations were responsible for different amounts of degeneration in the cervical and thoracolumbar intervertebral discs . These findings are consistent with the local occurrence of HNPE more frequently reported in the cervical region and consisting of less calcified disc material.…”

Section: Discussionmentioning

confidence: 93%

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Comparison of surgical and conservative treatment of hydrated nucleus pulposus extrusion in dogs

Neßler

Flieshardt²,

Tünsmeyer

et al. 2018

Veterinary Internal Medicne

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BackgroundWhether compressive cervical myelopathy caused by hydrated nucleus pulposus extrusion (HNPE) in dogs should be treated surgically or conservatively has been debated. Only 1 recent study has contradicted the former predominant reports of surgical treatment for HNPE.Hypothesis and methodSingle center retrospective study to compare the outcome of client‐owned dogs with HNPE after decompressive surgery or conservative treatment.AnimalsThirty‐six dogs diagnosed with HNPE confirmed by magnetic resonance imaging (MRI).ResultsEighteen of 36 dogs underwent surgery whereas 18 dogs were managed conservatively including cage rest and physiotherapy. The most common affected intervertebral disc space was C4‐5. In 3 dogs, HNPE was diagnosed at the level of T13‐L1. Median time to regain ambulation was 6.6 days (range, 0‐28 days) after surgery and 5.9 days (range, 0‐15 days) with conservative management (P = .37).Only the length of a potential intramedullary lesion in cervical HNPE detected by MRI had an influence on the prognosis to gain ambulatory status in a time period of ≤9 days (P = .0035) and on short‐term survival (P = .0011).Conclusions and clinical importanceConservative management of HNPE in the cervical as well as in the thoracolumbar region represents a reasonable alternative to surgery, showing similar favorable outcome.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Comparison of surgical and conservative treatment of hydrated nucleus pulposus extrusion in dogs

Neßler

Flieshardt²,

Tünsmeyer

et al. 2018

Veterinary Internal Medicne

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“…Histopathological studies of extruded disc material from dogs have been published previously [25–29], but to the authors’ knowledge, only one study [25] concerns specimens obtained exclusively from dachshunds. However, in that study inflammation was well described while information about mineralization is not included.…”

Section: Discussionmentioning

confidence: 99%

“…However, in that study inflammation was well described while information about mineralization is not included. In other histopathological studies [26–29], the percentage of dachshunds from which disc material is collected, ranges from 9.1 [29] to 51.1 [26]. In the study with the highest percentage [26], specimens were obtained intraoperatively from a total of 45 dogs, of which 23 (51.1%) were dachshunds.…”

Section: Discussionmentioning

confidence: 99%

Calcification of extruded intervertebral discs in dachshunds: a radiographic, computed tomographic and histopathological study of 25 cases

2019

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Background Three Nordic countries have national breeding programs to reduce the frequency of intervertebral disc disease in dachshunds. The programs include a radiographic examination of the vertebral column and dachshunds with more than four calcified discs visible on radiographs (CDVR) are discouraged from use in breeding. However, disc extrusion is also diagnosed in dachshunds without CDVR. The utility of the breeding programs is therefore questioned. Results A prospective study of 25 dachshunds surgically treated for disc extrusion was conducted. For all the dogs, preoperative radiographs were evaluated for detectable disc calcifications and preoperative computed tomography (CT) scans were evaluated for presence of calcified material in the vertebral canal. Postoperatively, extruded disc material was examined for degeneration and calcification by histology. Diagnostic imaging and histology were done independently. Radiographically visible calcification was identified in 17 (68.0%) of 25 extruded discs. Calcification was seen in the disc space for all these 17 discs, and for eight of the 17, there was also calcified material visible in the vertebral canal. Extruded material from all the 25 discs was found to be calcified, both by CT and histopathology. Conclusions In dachshunds with acute disc extrusion, radiographically visible calcification will frequently be found in the affected disc space, but not all affected disc spaces contain radiographically visible calcification. Using histopathology as the gold standard, a sensitivity of 0.3 (8/25) for radiography and 1.0 (25/25) for CT was found for detecting calcified disc material in the vertebral canal. Further, a sensitivity of 0.7 (17/25) was found for radiography for detecting remaining calcified material in the disc space. Thus, extruded disc material should be considered to be calcified, even in the absence of radiographically visible calcification.

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“…MRI was performed with a high ield unit (1.5 T, Intera, Phillips Medical Systems) under general anaesthesia. Guidelines for the MRI characterisation of intervertebral disc extrusion (IVDE), [15][16][17][18] intervertebral disc protrusion (IVDP), 17 19 neoplasms 9 20-22 and SM 23 24 were used in making a radiological diagnosis. Cases of osseousassociated and disc-associated CSM were grouped together and diagnosed based on previously reported MRI criteria.…”

Section: Methodsmentioning

confidence: 99%

Clinical reasoning in canine cervical hyperaesthesia: which presenting features are important?

2020

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BackgroundTo evaluate whether clinical features from the history, presentation, physical and neurological examination of dogs with cervical hyperaesthesia are statistically predictive of the underlying diagnosis.MethodsTwo hundred and ninety-eight dogs presenting with cervical hyperaesthesia between January 2010 and October 2018 were investigated. Only neurologically normal dogs with cervical hyperaesthesia on examination were included, while those with concurrent neurological deficits including gait abnormalities and proprioceptive deficits were excluded. Univariate analysis of clinical variables was performed, and those associated with each diagnosis were retained for multivariable binary logistic regression models.ResultsNinety-five per cent of cervical hyperaesthesia presentations were represented by eight conditions that included steroid-responsive meningitis arteritis (SRMA; n=100), intervertebral disc extrusion (n=78), syringomyelia (SM; n=51), intervertebral disc protrusion (n=30), neoplasia (n=8), cervical spondylomyelopathy (n=7), immune-mediated polyarthritis (n=5) and meningoencephalomyelitis of unknown aetiology (n=5). Younger age (P=0.003), pyrexia (P=0.003) and haematology abnormalities (P=0.03) comprising leucocytosis, neutrophilia or monocytosis were associated with a diagnosis of SRMA.ConclusionsEasy-to-recognise clinical features can be used to identify the most likely differential diagnosis in neurologically normal dogs with cervical hyperaesthesia, which may aid the decision making of veterinary surgeons evaluating dogs with this presentation.

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Differences in Epidural Pathology between Cervical and Thoracolumbar Intervertebral Disk Extrusions in Dogs

Cited by 14 publications

References 36 publications

Comparison of surgical and conservative treatment of hydrated nucleus pulposus extrusion in dogs

Comparison of surgical and conservative treatment of hydrated nucleus pulposus extrusion in dogs

Calcification of extruded intervertebral discs in dachshunds: a radiographic, computed tomographic and histopathological study of 25 cases

Clinical reasoning in canine cervical hyperaesthesia: which presenting features are important?

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