MRI findings, surgical treatment and follow-up of a myelomeningocele with tethered spinal cord syndrome in a cat

Abstract

A 7-month-old male neutered cat was referred for paraparesis and painful sensation at the level of T13 vertebra where a dermal cyst was observed. Spine radiographs and magnetic resonance imaging (MRI) showed a well-encapsulated cyst communicating with the meninges and spinal cord, suggestive of hydromyelia and myelodysplasia. Dorsal laminectomy was performed and the cyst was completely removed. The day after surgery, the cat was ambulatory paraparetic. Involuntary defecation was observed for only a few days. The surgical specimen was cystic and covered by skin. Microscopic examination revealed a hollow hemispheric mass of glial fibrillary acidic protein (GFAP)-positive neural tissue lined by ependyma and formed of glia and vascular structures consistent with myelomeningocele (MMC). Only anecdotal descriptions of MMC have been published in the veterinary literature, mainly in the lumbosacral spinal cord. To the authors' knowledge, this is the first report of a MMC with tethered spinal cord syndrome in a cat successfully treated surgically.

Tethered cord syndrome with spina bifida aperta in cats: two case reports of different types

“…3 In veterinary medicine, TCS has been reported in conjunction with intradural lipoma, meningomyeloceles, spina bifida, myeloschisis and split cord malformation. 4–7,20,21 In humans, the early symptoms of TCS include ataxia in the lower extremities, muscle weakness and vesicorectal failure (including urinary urgency and urinary and faecal incontinence). 22 TCS in case 1 occurred in the lumbosacral region and appeared with similar clinical signs as those in humans.…”

“…2 Although TCS occurs secondary to SBA in humans, 3 it has not been examined in as much detail in veterinary medicine. 4–7 We herein report two feline cases of TCS with SBA for which imaging characteristics, surgical treatments and outcomes are presented.…”

Dura mater marsupialisation and outcome in a cat with a spinal subarachnoid pseudocyst: a case report

“…Considering the good recovery starting immediately after the surgery, the severe neurological condition observed was probably principally due to the spinal cord compression maintained by the CSF accumulation in the pseudocysts. Although MRI is considered the gold standard for diagnosis of subarachnoid pseudocysts, myelography and myelo-CT still represent useful diagnostic techniques in most instances (Galloway et al 1999;Vignoli et al 1999;DeLahunta and Glass 2009b;Sharp and Wheeler 2009;Sugiyama and Simpson 2009;Ricci et al 2011). In our case the CT scan was essential to investigate in more detail the vertebral body structure and the spinal cord compression.…”

“…This allowed the identification of the previous fracture of the L1 vertebra as a possible causative factor. The treatment of subarachnoid pseudocysts typically requires a surgical approach (Sharp and Wheeler 2009) that considers two different entries to the spinal cord: dorsal laminectomy (McKeen and Renwick 1994;Frykman 1999;Sugiyama and Simpson 2009;Ricci et al 2011) or hemilaminectomy (Shamir et al 1997;Gnirs et al 2003;Schmidt et al 2007). Two different treat- ments can be performed, the simple fenestration technique (durotomy or durectomy) (Shamir et al 1997;Frykman 1999;Jurina and Grevel 2004;Sugiyama and Simpson 2009;Ricci et al 2011), or durotomy associated with dura mater marsupialisation (McKeen and Renwick 1994;Jurina and Grevel 2004;Schmidt et al 2007;Sharp and Wheeler 2009).…”

“…Two different treat- ments can be performed, the simple fenestration technique (durotomy or durectomy) (Shamir et al 1997;Frykman 1999;Jurina and Grevel 2004;Sugiyama and Simpson 2009;Ricci et al 2011), or durotomy associated with dura mater marsupialisation (McKeen and Renwick 1994;Jurina and Grevel 2004;Schmidt et al 2007;Sharp and Wheeler 2009). As many authors suggest (McKeen and Renwick 1994;Sugiyama and Simpson 2009;Ricci et al 2011), we performed a dorsal laminectomy and marsupialisation, with consideration of the better reported outcome (McKeen and Renwick 1994;Jurina and Grevel 2004). Simple durotomy or durectomy represent good techniques for treatment of subarachnoid pseudocysts but, in the authors' opinion, neither maintain persistent drainage of the pseudocysts since they often show recurrence (Frykman 1999;Sugiyama and Simpson 2009 (Palmer 1974), whilst in cats, to our knowledge, only one case was briefly described (Schmidt et al 2007).…”