Radiological evaluation of ‘wobbler’ syndrome -caudal cervical spondylomyelopathy

Clinical and diagnostic imaging findings in a bengal tiger (Panthera tigris tigris) with cervical spondylomyelopathy: A case report

An adult neutered male Bengal tiger (Panthera tigris tigris) presented with abnormal gait. Neurological examination showed poor left ambulatory hemiparesis, spontaneous proprioceptive deficit in the left anterior limb, and decreased flexor reflex in the forelimbs. The neurological symptoms suggested a caudal cervical spinal cord lesion. Pathological findings included increased cholinesterase and protein levels in the cerebrospinal fluid. Computed tomography examination revealed C2-C3 intervertebral disc herniation, C5-C6 intervertebral disc herniation associated with a reduction of the intervertebral space, and mild ventral dislocation of the C6 vertebra compared to C5. In addition, severe bilateral shoulder osteoarthritis and a hypoattenuating nodule in the left thyroid gland with an open etiology were observed. These findings were interpreted as indicating cervical spondylomyelopathy (CSM). Treatment included analgesic and steroidal anti-inflammatory therapy as well as movement restriction. Follow-up at 4 weeks showed modest improvement. Thus, CSM should be included in the differential diagnosis of tigers with neurological cervical signs.

Surgical management and long-term outcome of dogs with cervical spondylomyelopathy with an anchored intervertebral titanium device

OBJECTIVE

To assess the short- and long-term outcome of an anchored intervertebral titanium device (C-LOX) for the treatment of 10 dogs with disc-associated cervical spondylomyelopathy (DACSM) and 1 dog with osseous-associated cervical spondylomyelopathy.

DESIGN

Retrospective case series.

METHODS

Dogs were included if they were diagnosed with either DACSM or osseous-associated cervical spondylomyelopathy via myelography with or without advanced imaging and underwent surgical distraction and stabilisation of the affected intervertebral disc with a C-LOX implant. Assessment included short-term neurological outcome, radiography immediately and 6 weeks' postsurgery, owner questionnaire and veterinary clinical assessment.

RESULTS

The mean follow-up time was 12 months. Improvement in neurological status was noted in 10 of 11 dogs. Screw loosening or subsidence occurred in five dogs. Revision surgery was performed in two dogs due to implant fracture (n = 1) and recurrence of spinal cord compression due to endplate subsidence around the implant (n = 1). Adjacent segment disease occurred in three dogs (30%) with DACSM at a mean of 11 months postsurgery.

CONCLUSION

The use of the C-LOX implant for dogs with cervical spondylomyelopathy resulted in a high rate of initial neurological improvement; however, there is a moderate incidence of minor and major complications that is comparable to previously described distraction-stabilisation techniques.

Evidence of congenital block vertebra in Pleistocene Cave Bear (Ursus spelaeus) from Cueva de Guantes (Palencia, Spain)

OBJECTIVE

This work provides a detailed description and differential diagnosis of a Pleistocene cave bear (Ursus spelaeus).

MATERIALS

The specimen was recovered at the Cueva de Guantes archaeo- paleontological site, located in the North of the Iberian Peninsula and dated to more than 30k yr BP.

METHODS

The study was carried out by macroscopic and radiological analysis.

RESULTS

The specimen has unusual morphology, with two vertebrae (C6-C7) connected in the ventrodorsal projection by osseous tissue, without a space or disruption between them. However, a separation is visible in the dorsoventral projection. Moreover, C7 shows a "wedge-shape" conformation.

CONCLUSIONS

The lack of clear radiological and macroscopic evidence of degenerative processes and trauma suggests a congenital anomaly or pathology. The short height of the ventral margin of the block and evidence of a radiological 'waist' lead us to propose congenital block vertebra (CBV) as the most likely diagnosis.

SIGNIFICANCE

The Cueva de Guantes specimen would be the first reported evidence of CBV in a Pleistocene cave bear (Ursus spelaeus).

LIMITATIONS

All diagnosis of archaeological animal remains should be undertaken with caution, especially when based on partial remains, as in this case. Moreover, this specimen lacks the neural arches of C6 and C7, preventing evaluation of the vertebral foramina.

SUGGESTIONS FOR FURTHER RESEARCH

Intensive review of cave bear skeletal collections is advised to find new cases and perform an epidemiological approach to the palaeopathology of cave bears.

Intervertebral Disc Degeneration in Warmblood Horses: Morphology, Grading, and Distribution of Lesions

Equine intervertebral disc degeneration is thought to be rare and of limited clinical relevance, although research is lacking. To objectively assess pathological changes of the equine intervertebral disc and their clinical relevance, description of the normal morphology and a practical, biologically credible grading scheme are needed. The objectives of this study are to describe the gross and histological appearance of the equine intervertebral discs and to propose a grading scheme for macroscopic degeneration. Spinal units from 33 warmblood horses were grossly analyzed and scored. Of the 286 intervertebral discs analyzed, 107 (37%) were assigned grade 1 and grade 2 (considered normal) and were analyzed histologically. A nucleus pulposus and an annulus fibrosus could be identified macroscopically and histologically. Histologically, the nucleus pulposus was composed of a cartilaginous matrix and the annulus fibrosus of parallel collagenous bands. A transition zone was also histologically visible. Intra- and inter-observer reliability scores were high for all observers. Higher grades were associated with greater age. Gross changes associated with equine intervertebral disc degeneration (grades 3-5)-that is, yellow discoloration, cleft formation (tearing), and changes in consistency of the nucleus pulposus-were largely similar to those in humans and dogs and were most prevalent in the caudal cervical spine. Equine intervertebral disc degeneration was not associated with osteophyte formation. Changes of the vertebral bone were most common in the thoracolumbar spine but were not correlated with higher grades of intervertebral disc degeneration. Thus, changes of the vertebral bone should be excluded from grading for equine intervertebral disc degeneration.

Evaluation of traditional and novel radiographic vertebral ratios in Great Danes with versus without cervical spondylomyelopathy

Great Danes are predisposed to osseous-associated cervical spondylomyelopathy (Wobbler syndrome). The first aim of this prospective study was to compare values measured using previously published intravertebral and intervertebral ratio methods and a novel ventrodorsal ratio method in radiographs of clinically normal and affected Great Danes. The second aim was to determine whether these ratios could be used as predictors of sites of spinal cord compression based on magnetic resonance imaging (MRI). Thirty dogs (15 normal, 15 affected) were prospectively enrolled. Lateral and ventrodorsal radiographs were obtained and six measurements were recorded from C3-T1. For each vertebral location, intravertebral ratios and intervertebral ratios were calculated from lateral views, and the ratio of the distance between the articular process joints vs. vertebral body width (novel ventrodorsal ratio) was calculated from ventrodorsal views. Values for these three ratios were compared, by vertebral location and dog group. Intravertebral and intervertebral ratios did not differ between dog groups. The ventrodorsal ratio was significantly smaller in affected Great Danes at C5-6 (P = 0.005) and C6-7 (P < 0.001). The ventrodorsal ratio was significantly associated with MRI presence of spinal cord compression. For each 0.1 unit increase in this ratio value, there was a 65% decrease in the odds of spinal cord compression being present at that site, independent of vertebral location (P = 0.002). Findings from this study supported use of the novel ventrodorsal ratio as an initial radiographic screening method for Great Danes with suspected cervical spondylomyelopathy.

Comparison of noncontrast computed tomography and high-field magnetic resonance imaging in the evaluation of Great Danes with cervical spondylomyelopathy

Computed tomography (CT) provides excellent bony detail, whereas magnetic resonance (MR) imaging is superior in evaluating the neural structures. The purpose of this prospective study was to assess interobserver and intermethod agreement in the evaluation of cervical vertebral column morphology and lesion severity in Great Danes with cervical spondylomyelopathy by use of noncontrast CT and high-field MR imaging. Fifteen client-owned affected Great Danes were enrolled. All dogs underwent noncontrast CT under sedation and MR imaging under general anesthesia of the cervical vertebral column. Three observers independently evaluated the images to determine the main site of spinal cord compression, direction and cause of the compression, articular process joint characteristics, and presence of foraminal stenosis. Overall intermethod agreement, intermethod agreement for each observer, overall interobserver agreement, and interobserver agreement between pairs of observers were calculated by use of kappa (κ) statistics. The highest overall intermethod agreements were obtained for the main site of compression and direction of compression with substantial agreements (κ = 0.65 and 0.62, respectively), whereas the lowest was obtained for right-sided foraminal stenosis (κ = 0.39, fair agreement). For both imaging techniques, the highest and lowest interobserver agreements were recorded for the main site of compression and degree of articular joint proliferation, respectively. While different observers frequently agree on the main site of compression using both imaging techniques, there is considerable variation between modalities and among observers when assessing articular process characteristics and foraminal stenosis. Caution should be exerted when comparing image interpretations from multiple observers.

Myelographic diagnosis and results of surgical treatment of caudal cervical spondylomyelopathy in dogs: a retrospective study (2000–2010)

The outcomes of six different surgical techniques of caudal cervical spondylomyelopathy treatment in dogs with static and dynamic spinal cord compressions were assessed. Out of 425 dogs with cervical spine diseases, caudal cervical spondylomyelopathy was diagnosed in 69 dogs. Dynamic myelographic study was performed in 48 of them as a diagnostic method necessary for choosing the appropriate technique of surgical treatment. Twenty-five out of the 48 dogs underwent surgery. The best results of the surgical treatment of static compression were achieved with a ventral slot (89% of the nine surgical interventions) with partial improvement 48 h after surgery and marked improvement 8 weeks after surgery. For dynamic compressions, vertebral traction and stabilization with intervertebral washer plus vertebral body screws and polymethylmethacrylate bridge was found to be the most successful surgical treatment with significant improvement in 62% of the thirteen surgical interventions 8 weeks after surgery. In 5 dogs (20%), two intervertebral spaces with caudal cervical spondylomyelopathy were surgically treated. Recurrence was observed in 6 dogs (24%) after the mean period of 20 months (5 to 44 months) after surgery. Direct ventral slot decompression could be recommended for clinical cases of the caudal cervical spondylomyelopathy with static compression, and intervertebral washer plus vertebral body screws and polymethylmethacrylate bridge for dogs with dynamic compression, respectively. Our findings refer to the results of surgical treatment in a relatively large number of dogs with caudal cervical spondylomyelopathy and can help surgeons to choose an effective surgical method of treatment in dogs with wobbler syndrome based on dynamic myelographic study findings.

Effect of ventral slot procedure on spinal cord compression in dogs with single static intervertebral disc disease: preliminary findings while evaluating a semiquantitative computed tomographic myelographic score of spinal cord compression

OBJECTIVE

To (1) evaluate pre- and postoperative cervical spinal cord compression (SCC) in the context of uncomplicated ventral slot (VS) decompression using computed tomographic (CT) myelography and (2) report reliability of a semiquantitative SCC score using CT myelography.

STUDY DESIGN

Prospective and retrospective, clinical pilot study.

ANIMALS

Dogs (n = 17) with single static intervertebral disc disease.

METHODS

On matched pre- and postoperative transverse CT myelographic images, degree and lateralization of extradural SCC were scored by 4 blinded independent observers, followed by consensus finding. Inter- and intraobserver variability was quantified using intraclass correlation (ICC). Nonparametric tests were performed comparing pre- and postoperative SCC, correlation with neurologic status and significance of lateralization.

RESULTS

Because of invisible contrast agent, only 13 dogs could be fully evaluated. After VS, SCC was significantly reduced whereas neurologic function significantly improved. Ten dogs had residual compression, not affecting neurologic long-term outcome. Only preoperative compression score and neurologic status 3-7 weeks postoperatively were inversely correlated. Lateralization of SCC preoperatively did not affect postsurgical compression scores. Interobserver ICC was 0.848 and intraobserver ICC was 0.984.

CONCLUSIONS

VS improves neurologic function but often fails at completely resolving extradural SCC. The proposed CT myelographic score is highly reliable, assuring consistency among and within observers.

Computed tomography myelographic findings in dogs with cervical spondylomyelopathy

Computed tomography (CT) myelography is used occasionally in the diagnosis of cervical spondylomyelopathy, but the type of lesion found in large- versus giant-breed dogs using this modality has not been characterized. Our purpose was to report the frequency of compressive lesions in large- and giant-breed dogs with cervical spondylomyelopathy and imaged using CT myelography. Fifty-eight dogs were retrospectively studied, 23 large-breed and 35 giant-breed dogs. Multiple sites of compression were found in 12 large-breed dogs (52.2%) compared to 30 (85.8%) giant-breed dogs. The main site of compression was at C5-6 and C6-7 in both large-breed (91.3%) and giant-breed (72.4%) dogs. The main cause and direction of compression was disc-associated and ventral in 19 (82.6%) of the large-breed dogs while osseous changes were the primary cause of compression in 27 (77.2%) of the giant-breed dogs, with most compressions being lateral (51.4%), followed by dorsolateral (14.2%). Osseous compression was observed at C7-T1 in eight giant-breed dogs (22.8%), and at T1-T2 or T2 only in five dogs (14.3%). Four of 23 large-breed dogs (17.4%), and seven (20%) of 35 giant-breed dogs had spinal cord atrophy. Therefore, giant-breed dogs often have multiple compressions, usually caused by osseous changes causing lateralized compressions. In large-breed dogs most compressions are disc-associated and located ventrally. Considering the number of giant-breed dogs with compressions at C7-T1, T1-2, and T2, it is important to include the cranial thoracic region when imaging dogs suspected of having cervical spondylomyelopathy.

One-year clinical and magnetic resonance imaging follow-up of Doberman Pinschers with cervical spondylomyelopathy treated medically or surgically

OBJECTIVE

To evaluate progression of clinical signs and magnetic resonance imaging (MRI) findings in dogs with cervical spondylomyelopathy (wobbler syndrome) treated medically or surgically.

DESIGN

Prospective cohort study.

ANIMALS

12 Doberman Pinschers.

PROCEDURES

Neurologic examinations and MRI were performed before medical (n = 9) or surgical treatment (ventral slot, 3) and a minimum of 12 months later.

RESULTS

Mean follow-up time was 14.5 months. Clinically, 2 dogs improved after surgical treatment and 5 improved after medical treatment. Magnetic resonance imaging of surgically treated dogs revealed adequate spinal cord decompression. Spinal cord signal changes were seen in 2 dogs before surgery, both of which had new signal changes at the same and adjacent sites during follow-up examination. One dog treated surgically developed 3 new areas of spinal cord compression. In the medically treated dogs, the severity of spinal cord compression at the time of follow-up examination was unchanged in 4 dogs, worse in 2 dogs, and improved in 3 dogs, but spinal cord atrophy was observed on transverse images. Four medically treated dogs had changes in spinal cord signal initially, but none developed new signal changes or compressions.

CONCLUSIONS AND CLINICAL RELEVANCE

Medical and surgical treatment improved or stabilized the clinical condition of most dogs. Surgical treatment appeared to hasten the development of additional areas of spinal cord compression and lesions in dogs with preoperative cord changes; however, the clinical importance of these changes was not determined. The progression of pathologic MRI abnormalities was notably less in medically treated dogs, compared with surgically treated dogs.

Imaging findings and surgical treatment of hemivertebrae in three dogs

CASE DESCRIPTION

3 immature screw-tailed dogs were evaluated because of progressive pelvic limb paraparesis.

CLINICAL FINDINGS

Each dog had marked ataxia and paresis of the pelvic limbs and a palpable deformity of the midthoracic portion of the vertebral column. Pain perception in the pelvic limbs was considered normal, and there was no evidence of fecal or urinary incontinence in any of the 3 dogs. Radiography and magnetic resonance imaging revealed hemivertebrae with severe dorsoventral stenosis of the vertebral canal resulting in spinal cord compression in 2 dogs and lateral compression in the other.

TREATMENT AND OUTCOME

Each dog underwent decompressive surgery consisting of dorsal laminectomy or hemilaminectomy and vertebral stabilization by use of combinations of Kirschner wires or threaded external fixator pins plus polymethylmethacrylate bone cement. All dogs regained strong locomotor function with minimal residual pelvic limb ataxia.

CLINICAL RELEVANCE

Little detailed information regarding surgical treatment of hemivertebrae in dogs is available; results of treatment in these 3 dogs suggest that spinal cord decompression and stabilization of the vertebral column can achieve a satisfactory, functional outcome.

Correlation of motor evoked potentials with magnetic resonance imaging and neurologic findings in Doberman Pinschers with and without signs of cervical spondylomyelopathy

OBJECTIVE

To establish the reference ranges for motor evoked potential (MEP) latency and amplitude in clinically normal Doberman Pinschers, compare the MEPs of Doberman Pinschers with and without clinical signs of cervical spondylomyelopathy (CSM; wobbler syndrome), and determine whether MEP data correlate with neurologic or magnetic resonance imaging (MRI) findings.

ANIMALS

16 clinically normal and 16 CSM-affected Doberman Pinschers.

PROCEDURES

Dogs were classified according to their neurologic deficits. After sedation with acepromazine and hydromorphone, transcranial magnetic MEPs were assessed in each dog; latencies and amplitudes were recorded from the extensor carpi radialis and cranial tibial muscles. Magnetic resonance imaging was performed to evaluate the presence and severity of spinal cord compression.

RESULTS

Significant differences in cranial tibial muscle MEP latencies and amplitudes were detected between clinically normal and CSM-affected dogs. No differences in the extensor carpi radialis MEP were detected between groups. There was a significant correlation (r = 0.776) between the cranial tibial muscle MEP latencies and neurologic findings. Significant correlations were also found between MRI findings and the cranial tibial muscle MEP latencies (r = 0.757) and amplitudes (r = -0.453).

CONCLUSIONS AND CLINICAL RELEVANCE

Results provided a reference range for MEPs in clinically normal Doberman Pinschers and indicated that cranial tibial muscle MEP latencies correlated well with both MRI and neurologic findings. Because of the high correlation between cranial tibial muscle MEP data and neurologic and MRI findings, MEP assessment could be considered as a screening tool in the management of dogs with spinal cord disease.

COMPARISON OF MAGNETIC RESONANCE IMAGING AND MYELOGRAPHY IN 18 DOBERMAN PINSCHER DOGS WITH CERVICAL SPONDYLOMYELOPATHY

Eighteen Doberman pinscher dogs with clinical signs of cervical spondylomyelopathy (wobbler syndrome) underwent cervical myelography and magnetic resonance (MR) imaging. Cervical myelography was performed using iohexol, followed by lateral and ventrodorsal radiographs. Traction myelography was performed using a cervical harness exerting 9 kg of linear traction. MR imaging was performed in sagittal, transverse, and dorsal planes using a 1.5 T magnet with the spine in neutral and traction positions. Three reviewers independently evaluated the myelographic and MR images to determine the most extensive lesion and whether the lesion was static or dynamic. All reviewers agreed with the location of the most extensive lesion on MR images (100%), while the agreement using myelography was 83%. The myelogram and MR imaging findings agreed in the identification of the affected site in 13-16 dogs depending on the reviewer. MR imaging provided additional information on lesion location because it allowed direct examination of the spinal cord diameter and parenchyma. Spinal cord signal changes were seen in 10 dogs. Depending on the reviewer, two to four dogs had their lesions classified as dynamic on myelography but static on MR images. Myelography markedly underscored the severity of the spinal cord compression in two dogs, and failed to identify the cause of the signs in another. The results of this study indicated that, although myelography can identify the location of the lesion in most patients, MR imaging appears to be more accurate in predicting the site, severity, and nature of the spinal cord compression.

Use Of Traction During Magnetic Resonance Imaging Of Caudal Cervical Spondylomyelopathy ("Wobbler Syndrome") In The Dog

Cervical spondylomyelopathy or "wobbler syndrome" is a well-defined disorder of large-breed dogs, characterized by a compressive lesion affecting the cervical spinal cord that in many dogs may have a dynamic component. Determination of whether this dynamic component is present is important in the decision-making process as regards therapeutic intervention. Despite a significant risk of neurologic deterioration following myelography in some large dogs affected by wobbler syndrome, myelography is considered an essential part of the assessment, primarily as it allows assessment of whether a dynamic compression exists. This same neurologic deterioration is not apparent following magnetic resonance (MR) imaging; however, the use of MR imaging in the investigation of wobbler syndrome has thus far been limited by the inability to perform the traction studies required to ascertain whether a dynamic component to the spinal cord compression exists. This paper presents a technique of applying traction during MR imaging of the cervical spine to reduce a dynamic wobbler syndrome lesion.

Dorsal laminectomy for caudal cervical spondylomyelopathy: postoperative recovery and long-term follow-up in 20 dogs

OBJECTIVE

To evaluate the postoperative morbidity and long-term outcome of dogs after dorsal laminectomy for caudal cervical spondylomyelopathy (CCSM).

STUDY DESIGN

Retrospective study.

SAMPLE POPULATION

Twenty dogs with CCSM.

METHODS

Medical records of dogs treated by dorsal laminectomy for CCSM at North Carolina State University and Colorado State University between 1989 and 1999 were reviewed. Information on signalment, onset, progression and duration of clinical signs, diagnostic testing, sites of dorsal laminectomy, postoperative complications, length of hospitalization, and the ambulatory status on discharge was recorded. A minimum follow-up of 7 months was required for inclusion in the study. Neurologic status was graded (0 to 5) preoperatively, 2 days after surgery, and at the time of the study (final score). Improvement or worsening of the neurologic status was assessed by comparison of different scores for each dog. Additional follow-up information was obtained by means of a detailed telephone questionnaire directed at both the owner and referring veterinarian.

RESULTS

Mean duration of clinical signs before surgery was 4.9 months. At admission, 15 dogs were ambulatory and 5 were nonambulatory. Neurologic status worsened in 70% of dogs 2 days after surgery but improved in all but 1 dog over the long term. Mean time to optimal recovery was 3.6 months. Long-term follow-up ranged from 7 months to 9 years (mean +/- SD, 3.2 +/- 2.4 years). Four dogs had confirmed recurrence; 2 other dogs may have had recurrence.

CONCLUSIONS

Dorsal cervical laminectomy is an effective treatment for CCSM in those dogs with dorsal compression or multiple sites of involvement.

CLINICAL RELEVANCE

Although most dogs' neurologic status transiently worsened after surgery, long-term outcome and recurrence rates were comparable to those seen with other surgical techniques for CCSM.

Magnetic resonance imaging features of cervical stenotic myelopathy in 21 dogs

The cervical spine of 21 dogs with clinical signs of cervical stenotic myelopathy was evaluated using magnetic resonance (MR) imaging. Spin echo T1, T2 and gradient echo T2 weighted images were obtained with a 1.5 Tesla magnet in 12 dogs and a 1.0 Tesla magnet in 9 dogs. Sagittal or parasagittal T1W and T2W images were helpful in determining the presence of spinal cord compression or degenerative disease of the articular processes. Transverse T1W and T2W images were the most useful for the identification of dorsolateral spinal cord compression secondary to soft tissue and ligament hypertrophy, as well as synovial cysts, associated with the articular processes. The MR imaging findings were consistent with the surgical findings in all 14 dogs that underwent surgery. Magnetic resonance imaging provided a safe, non-invasive method of evaluating the cervical spine in dogs suspected of having cervical stenotic myelopathy. Veterinary

Intervertebral disk disease

Neurologic dysfunction is the most common clinical manifestation of intervertebral disk disease. This article is a comprehensive review of intervertebral disk disease emphasizing clinical features, diagnosis and treatment of cervical and thoracolumbar disk disease. Clinical signs are determined by neuroanatomic localization and severity of spinal cord injury. Myelography is most commonly used for determining the location and extent of the disk protrusion/extrusion; however, computed tomography and magnetic resonance imaging are also common adjunctive and primary diagnostic techniques. Summaries from recent studies will give the clinician an improved understanding on how to confront controversial issues regarding prophylactic and therapeutic management and prognosis.

Management of cervical spondylopathy-associated intervertebral, disc protrusions using metal washers in 78 dogs

Intervertebral 7.5 mm (n = 75) and 6.0 mm (n = 22) metal washers were used to distract intervertebral spaces in 78 consecutive cases of canine cervical spondylopathy-associated disc protrusions, where myelography had demonstrated traction-responsive spinal cord compression. Nineteen dogs had compressive lesions at two sites. Fifty lesions were evaluated myelographically on immediate postoperative radiographs; of these, 32 compressions had been eliminated and 18 had been reduced. Euthanasia was performed in nine dogs within six months of surgery and 15 dogs had varying degrees of neck pain during this period. Long-term follow-up information was available on 65 dogs nine to 70 months following surgery (median 32 months). Sixty-three of these dogs improved postoperatively. Neurological function subsequently deteriorated in 17 dogs 10 to 59 months following surgery (median 34 months). Eight of these 17 cases had further myelographic investigations and all had additional disc protrusions with no evidence of cord compression at the previous sites of surgery. The remaining nine cases had a deterioration in hindlimb function but were not investigated further.

The spine

Computed tomography (CT) and magnetic resonance imaging (MRI) are becoming increasingly accessible in veterinary medicine. Because of their ability to image the bony spine and spinal cord noninvasively and with exceptional detail, these techniques have revolutionized the way spinal disorders are diagnosed in both people and animals. Although the veterinary literature on this topic is limited, interpretation of CT and MR images of the spine are facilitated by the similarity of human and animal disease processes. This article provides an overview of imaging strategies, normal anatomy, and the CT and MRI features of degenerative, infectious, neoplastic, and vascular diseases of the spine.

Comparison of two surgical techniques for the management of cervical spondylomyelopathy in dobermanns

A study was undertaken to compare the efficacy of two surgical techniques for the treatment of caudal cervical spondylomyelopathy (CCSM): ventral decompression (slot) and vertebral distraction and stabilisation with a screw and washer (screw/washer). Twenty-eight dobermanns managed surgically for disc-associated CCSM during a four-year period were studied retrospectively. The maximum postoperative period was 40 months. Cases were excluded if a minimum follow-up of 24 months after surgery could not be made. A 'slot' took a longer time to perform and had a higher rate of immediate postoperative deterioration. Duration of hospital stay was similar for both procedures. At six months after surgery the two techniques were comparable; 12/14 (screw/washer) and 13/14 (slot) patients were deemed to have a satisfactory outcome. Recurrence of cervical spinal cord disease was higher in the screw/washer dogs. At one year after surgery the recurrence rate was zero (slot) and 5/14 (screw/washer), respectively. At two years after surgery 4/14 of the slot dogs had deteriorated compared to 7/14 of the screw/washer dogs. Where investigated, the cause of deterioration was either a domino disc lesion or vertebral endplate collapse and dorsal displacement of the screw and washer.

Management of disc-associated wobbler syndrome with a partial slot fenestration and position screw technique

A previously unpublished surgical technique for the management of disc-associated wobbler syndrome is described. A series of 17 middle-aged dobermanns (mean age 7.4 years) with this condition were managed by a technique of partial slot fenestration and position screw fixation of the affected disc space (C6/7 in all cases). One patient was lost to follow-up and, of the remaining 16 cases, 13 improved following surgery (81 per cent). The three failures were a consequence of incorrect placement of one of the screws. Careful evaluation of immediate postoperative radiographs allows this problem to be identified; the screw can then be correctly repositioned with an immediate return to surgery.

Common neurologic diseases of older animals

Of the various neurologic diseases that affect dogs and cats, some are more often encountered in older animals. Physical diagnosis may be challenging, as multiple disease processes that may minic neurologic disease can be present in the same animal. A diligent, complete neurologic examination should lend for an accurate neuroanatomical diagnosis. Once a level of involvement is determined, knowledge of diseases affecting the particular area of the nervous system will provide for appropriate diagnosis, treatment, and prognosis. Although neurologic diseases are still often devastating, successful management of many of these diseases will afford better quality of life during the geriatric years.