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Kramer V, Böttcher P. Mapping Subchondral Bone Density Distribution in the Canine C6-C7 Vertebral Endplates: A CT-OAM Study. Animals (Basel) 2023; 13:3432. [PMID: 38003050 PMCID: PMC10668868 DOI: 10.3390/ani13223432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023] Open
Abstract
Intervertebral cage subsidence is a common complication in treating disc-associated cervical spondylomyelopathy in dogs. The mechanical stability of the vertebral endplate in contact with the cage is crucial to preventing subsidence. This study aims to assess subchondral bone mineral density (sBMD) in the canine vertebral endplate (specifically, the C6-C7 vertebral motion unit) as a measure of its mechanical stability. The sBMD distribution was mapped for the C6 caudal and C7 cranial vertebral endplates in 15 middle- to large-breed dogs using computed tomography osteoabsorptiometry. The sBMD distribution in the canine C6 and C7 vertebral endplates exhibited a heterogeneous pattern, with lower density observed in the central and dorsal contact areas of the nucleus pulposus, where common subsidence occurs. Our results suggest a potential need to redesign intervertebral cages to ensure that contact areas align with regions of higher bone density. A broad-based design extending toward the lateral and dorsal aspects of the annulus fibrosus contact area may enhance stability.
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Affiliation(s)
- Vincenz Kramer
- Small Animal Clinic, Freie Universität Berlin, 14163 Berlin, Germany;
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Bonelli MDA, da Costa RC. Magnetic resonance imaging and neurologic characterization of combined osseous- and disc-associated cervical spondylomyelopathy in dogs. J Vet Intern Med 2023; 37:1418-1427. [PMID: 37314024 PMCID: PMC10365061 DOI: 10.1111/jvim.16792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/26/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Although both disc- or osseous-associated forms of cervical spondylomyelopathy (CSM) are observed in the same dogs, this combined form has not been thoroughly evaluated. OBJECTIVES To describe imaging characteristics of dogs with concurrent disc- and osseous CSM and investigate an association between findings on neurological examination and imaging. ANIMALS Sixty dogs with disc and osseous-associated CSM from 232 CSM-affected dogs. METHODS Retrospective study. Dogs diagnosed via high-field MRI with a combination of intervertebral disc (IVD) protrusion and osseous proliferation of articular processes, dorsal lamina, or both were identified. Large and giant breed dogs were grouped according to whether combined compressions were at the same site or different sites. Statistical methods were used to investigate the association and relationship between variables. RESULTS Thirty-five out of 60 (58%) were large breeds and 22/60 (37%) were giant breeds. Mean and median age was 6.6 and 7 years respectively (range, 0.75-11 years). Forty of the 60 dogs (67%) had concurrent osseous and disc-associated spinal cord compression in the same location. This was considered the main compression site in 32/40 (80%) dogs. Dogs with osseous- and disc-associated compressions at the same site were more likely to have a higher neurologic grade (P = .04). CONCLUSIONS AND CLINICAL IMPORTANCE A substantial percentage of dogs with CSM present with concomitant IVD protrusion and osseous proliferations, most at the same site. Characterizing this combined form is important in the management of dogs with CSM because it could affect treatment choices.
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Affiliation(s)
| | - Ronaldo Casimiro da Costa
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
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Lee N, Seo J, Yoon J. Morphometric Magnetic Resonance Imaging Evaluation of Cervical Spinal Canal and Cord in Normal Small-Breed Dogs. Front Vet Sci 2021; 8:732953. [PMID: 34660768 PMCID: PMC8511692 DOI: 10.3389/fvets.2021.732953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
Cervical spinal disease is one of the most common neurological disorders in small-breed dogs. Magnetic resonance imaging (MRI) is a common test for dogs with cervical spinal diseases. However, there is no information on cervical spinal canal and cord using MRI in normal small-breed dogs. Therefore, this study aimed to perform analyses to establish morphologic MRI reference ranges of the cervical spinal canal and cord in normal small-breed dogs. Cervical MRI examinations were taken in 20 client-owned small dogs. The height, width, and cross-sectional area (CSA) of the spinal canal and cord were measured on sagittal and transverse T2-weighted images at each vertebral body level and each intervertebral disk level from C1-C2 to C7 (a total of 12 levels). The height ratio, the width ratio, and the CSA ratio were calculated. The height, width, and CSA of the spinal canal and cord increased as the dog's weight increased (p < 0.01), except for that at C1-C2. However, there was no correlation between the body weight and height ratio and the width ratio and CSA ratio at all levels, except for that at C1-C2. Also, there was a negative correlation between the body weight and CSA ratio at C1-C2. There were no statistical differences for the CSA of the spinal canal, the CSA of the spinal cord, and the CSA ratio between nearby levels, except for that at C1-C2. There was no statistical difference between measurements at each same level of the sagittal and transverse images. The results of this study may provide basic and morphometric information for diagnosing and researching cervical spinal diseases in small-breed dogs.
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Affiliation(s)
- Namsoon Lee
- Time Animal Medical Center, Daejeon, South Korea.,College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | | | - Junghee Yoon
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
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Poad L, Smith M, De Decker S. Comparing the clinical presentation and outcomes of dogs receiving medical or surgical treatment for osseous-associated cervical spondylomyelopathy. Vet Rec 2021; 190:e831. [PMID: 34409617 DOI: 10.1002/vetr.831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study aimed to compare the clinical presentation, short and long term outcomes of dogs treated surgically or medically for Osseous associated cervical spondylomyelopathy. METHODS Information collected retrospectively from medical records included signalment, neurological status and treatment type. Surgical treatment consisted of dorsal laminectomy. Medical treatment involved restricted exercise and medication. Improvement or deterioration in neurological status was determined at discharge, re-examination 4-8 weeks post-treatment and by telephone interview with the referring veterinary surgeon or owner at the time of the study, which ranged from 8-54 months following the discharge (median, 16 months). RESULTS Twenty-four dogs were treated surgically and 30 medically. Neurological grade at clinical presentation was significantly higher in surgically treated dogs (p = 0.004). Transient early postoperative neurological deterioration occurred in 73.1% of surgically treated dogs. For medical cases, long term improvement was seen in 15% of cases, remained static in 40% and deterioration in 45%. Surgical treatment resulted in long term improvement in 67% of cases, remained static in 29% and deterioration in 4% of cases. CONCLUSION This study suggests that surgery is a favourable treatment option, however, requires intensive post-operative care. Medical treatment was associated with a guarded prognosis but could be a viable treatment option for selected dogs.
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Affiliation(s)
- Lydia Poad
- Department of Clinical Science and Services, Royal Veterinary College, University of London Hatfield, Hertfordshire, UK
| | - Megan Smith
- Department of Clinical Science and Services, Royal Veterinary College, University of London Hatfield, Hertfordshire, UK
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London Hatfield, Hertfordshire, UK
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Bonelli MDA, da Costa LBDSBC, da Costa RC. Association of neurologic signs with high-field MRI findings in 100 dogs with osseous-associated cervical spondylomyelopathy. Vet Radiol Ultrasound 2021; 62:678-686. [PMID: 34370359 DOI: 10.1111/vru.13014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/29/2022] Open
Abstract
Although osseous-associated cervical spondylomyelopathy (OA-CSM) findings have been well described using magnetic resonance imaging (MRI), there are no large-scale published studies on the associations between dog size, age, high-field MRI and neurologic findings. Using a retrospective, observational study design, we aimed to investigate an association between neurologic and high-field MRI characteristics in OA-CSM. Records were reviewed for dogs diagnosed with OA-CSM using high-field MRI. One-hundred dogs were included: 73/100 (73%) were giant breeds, 27/100 (27%) large breeds. Mean and median ages were, respectively, 3.1 and 2 years (0.3-9.75 years), with 2.6 and 2 years for giant-breed; and 4.4 and 4 years for large-breed dogs. The majority of dogs were male (75%) with chronic presentation (89%), more than one site of spinal cord compression (78%) and foraminal stenosis (91%). Dogs with multiples sites of spinal cord compression were more likely to have severe spinal cord compression (p < 0.001), severe foraminal stenosis (p < 0.001) and ligamentum flavum/soft tissue proliferation (p = 0.03) than those with a single compressive site. There was a weak correlation between neurologic grade and severity of spinal cord compression (r = 0.27; p = 0.007), number of affected sites (r = 0.24; p = 0.0183) and spinal cord T2W hyperintensity (r = 0.24; p = 0.0152). Intervertebral disc degeneration was seen in 80% of dogs. Age did not appear to have a prominent role in the manifestation of OA-CSM. This study showed that OA-CSM affects a sizeable proportion of young large-breed, in addition to giant-breed dogs.
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Affiliation(s)
- Marília de Albuquerque Bonelli
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | | | - Ronaldo Casimiro da Costa
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
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Bonelli MDA, da Costa LBDSBC, da Costa RC. Magnetic resonance imaging and neurological findings in dogs with disc-associated cervical spondylomyelopathy: a case series. BMC Vet Res 2021; 17:145. [PMID: 33827551 PMCID: PMC8025371 DOI: 10.1186/s12917-021-02846-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Canine cervical spondylomyelopathy can be separated into osseous and disc-associated (DA-CSM) forms. Our aim was to describe the magnetic resonance imaging (using a high-field scanner) and neurological findings in dogs with DA-CSM and investigate a relationship between these findings. Results Sixty-three dogs were included: 60/63 (95 %) were large breeds, with Doberman Pinschers and males over-represented (70 %). Mean and median age at the time of diagnosis was 7.25 and 7.2 years (range 0.41–12 years). Chronic signs were noted in 52/63 (83 %) dogs, with proprioceptive ataxia the most common. Main site of spinal cord compression was commonly C6-7 or C5-6. Thirty-six (57 %) dogs had various sites of spinal cord compression. Most dogs younger than 6 years of age had a single affected site. Foraminal stenosis was present in 51/63 dogs (81 %). T2-weighted hyperintensity was present in 40/63 dogs (63 %). 88 % of the articular processes showed degenerative changes, which correlated strongly with intervertebral disc degeneration. Ligamentum flavum hypertrophy was seen in 38 % of dogs. No correlation was observed between neurologic signs and number of affected sites. A moderate positive correlation was observed between severity of spinal cord compression and neurologic grade (r 0.48; p < 0.001). Conclusions DA-CSM was predominantly observed in older, male Dobermans, with lesions located in the caudal cervical vertebral region. It was also seen in dogs 3 years of age or even younger (8 %). Single compressive lesions were more common in dogs younger than 6 years of age. Many dogs had concomitant changes (e.g.: ligamentum flavum hypertrophy and foraminal stenosis). Most dogs with ligamentum flavum hypertrophy were 6 years or older. A positive correlation was observed between severity of spinal cord compression and neurologic grade, but multilevel compression was not associated with more severe neurologic signs. A very high percentage of dogs had articular process degenerative changes. Possible biomechanical or genetic relationships between degenerative changes in articular processes, ligamentum flavum, and intervertebral discs warrants further investigation.
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Affiliation(s)
- Marília de Albuquerque Bonelli
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St, OH, 43210, Columbus, USA
| | | | - Ronaldo Casimiro da Costa
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St, OH, 43210, Columbus, USA.
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Gillespie S, De Decker S. Thoracic vertebral canal stenosis in cats: clinical features, diagnostic imaging findings, treatment and outcome. J Feline Med Surg 2020; 22:1191-1199. [PMID: 32436803 PMCID: PMC10814363 DOI: 10.1177/1098612x20920041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to describe the clinical features, diagnostic imaging findings, treatment and outcome in cats with thoracic vertebral canal stenosis (TVCS). METHODS Medical records and imaging studies of cats with TVCS were retrospectively reviewed. Outcome was acquired from patient records and from owners or referring veterinary surgeons via a telephone questionnaire. For each case, breed-, age- and sex-matched controls were identified with CT imaging of the thoracic vertebral column. For each cat, vertebral canal height was determined at three levels for each thoracic vertebra. Vertebral canal heights were compared between control cats of different breeds and between affected and control cats of the same breed. RESULTS Nine TVCS cases were included. British Shorthairs and male neutered cats were over-represented (P <0.05). Median age at presentation was 9 years. All cats were presented for a chronic, progressive, painful, ambulatory, T3-L3 myelopathy. Five cats were treated conservatively, three surgically and one was euthanased. Two cats treated surgically demonstrated improvement of clinical signs and one demonstrated initial improvement followed by deterioration. Of the conservatively treated cats, three deteriorated and two improved. Compared with controls, affected cats had a lower vertebral canal height at multiple thoracic vertebral levels, being most prominent for British Shorthairs and domestic shorthairs (P <0.05). Unaffected British Shorthairs had a lower thoracic vertebral canal height at multiple levels than control domestic shorthairs (P <0.05). CONCLUSIONS AND RELEVANCE TVCS should be considered a differential diagnosis in middle-aged to older cats presenting with a chronic, progressive, painful, T3-L3 myelopathy. The predisposition of British Shorthairs could be explained by a narrower vertebral canal in this breed.
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Affiliation(s)
- Sabrina Gillespie
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Steven De Decker
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
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King JC, Corfield GS, Mouatt JG, Kan CY, Moses PA. Surgical management and long-term outcome of dogs with cervical spondylomyelopathy with an anchored intervertebral titanium device. Aust Vet J 2020; 98:156-163. [PMID: 32037520 DOI: 10.1111/avj.12910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 12/11/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- J C King
- Veterinary Specialist Services - Small Animal Surgery Department, Gold Coast, Queensland, Australia
| | - G S Corfield
- Veterinary Specialist Services - Small Animal Surgery Department, Gold Coast, Queensland, Australia
| | - J G Mouatt
- Veterinary Specialist Services - Small Animal Surgery Department, Gold Coast, Queensland, Australia
| | - C Y Kan
- Veterinary Specialist Services - Small Animal Surgery Department, Gold Coast, Queensland, Australia
| | - P A Moses
- Veterinary Specialist Services - Small Animal Surgery Department, Gold Coast, Queensland, Australia
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Milodowski EJ, Amengual‐Batle P, Beltran E, Gutierrez‐Quintana R, De Decker S. Clinical findings and outcome of dogs with unilateral masticatory muscle atrophy. J Vet Intern Med 2019; 33:735-742. [PMID: 30556930 PMCID: PMC6430959 DOI: 10.1111/jvim.15373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 11/06/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Little is known about the spectrum of underlying disorders in dogs with unilateral masticatory muscle (MM) atrophy. OBJECTIVES To evaluate the clinical presentation, magnetic resonance imaging (MRI) findings, and outcome of dogs with unilateral MM atrophy. ANIMALS Sixty-three client-owned dogs. METHODS The medical database was retrospectively reviewed for dogs that underwent MRI for evaluation of unilateral MM atrophy. Imaging studies were reviewed and follow-up information was obtained from telephone interviews. RESULTS Presumptive trigeminal nerve sheath tumor (pTNST) was diagnosed in 30 dogs (47.6%); survival time varied from 1 day to 21 months (median, 5 months). Other extra-axial mass lesions were observed in 13 dogs (20.6%); survival time varied from 6 days to 25 months (median, 2.5 months). In 18 dogs (28.6%), no abnormalities were observed on MRI; neurological signs only progressed in 1 dog. Diagnosis had a significant influence on the type of neurological abnormalities, with additional neurological deficits observed in most dogs with pTNST and in all dogs with other extra-axial mass lesions. Diagnosis had a significant effect on euthanasia at the time of diagnosis and likelihood of neurological deterioration. Dogs with mass lesions were more likely to be euthanized or experience neurological deterioration, whereas these outcomes occurred less often in dogs in which no causative lesion could be identified. CONCLUSIONS AND CLINICAL IMPORTANCE Trigeminal nerve sheath tumors should not be considered the only cause of unilateral MM atrophy. Our results illustrate the importance of performing a neurological examination and MRI when evaluating dogs with unilateral MM atrophy.
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Affiliation(s)
- Emily Jayne Milodowski
- Department of Veterinary Clinical Science and Services, Royal Veterinary CollegeUniversity of LondonHatfieldEnglandUnited Kingdom
| | - Pablo Amengual‐Batle
- School of Veterinary Medicine, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowScotlandUnited Kingdom
| | - Elsa Beltran
- Department of Veterinary Clinical Science and Services, Royal Veterinary CollegeUniversity of LondonHatfieldEnglandUnited Kingdom
| | - Rodrigo Gutierrez‐Quintana
- School of Veterinary Medicine, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowScotlandUnited Kingdom
| | - Steven De Decker
- Department of Veterinary Clinical Science and Services, Royal Veterinary CollegeUniversity of LondonHatfieldEnglandUnited Kingdom
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Foss KD, Smith RL, da Costa RC. Kinetic and kinematic follow-up gait analysis in Doberman Pinschers with cervical spondylomyelopathy treated medically and surgically. J Vet Intern Med 2018; 32:1126-1132. [PMID: 29572944 PMCID: PMC5980253 DOI: 10.1111/jvim.15096] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/24/2018] [Accepted: 02/13/2018] [Indexed: 01/01/2023] Open
Abstract
Background The efficacy of treatment of dogs with cervical spondylomyelopathy (CSM) is commonly based on the owner's and clinician's perception of the gait, which is highly subjective and suffers from observer bias. Hypothesis/Objectives To compare selected kinetic and kinematic parameters before and after treatments and to correlate the findings of gait analysis to clinical outcome. Animals Eight Doberman Pinschers with CSM confirmed by magnetic resonsance imaging. Methods Patients were prospectively studied and treated with either medical management (n = 5) or surgery (n = 3). Force plate analysis and 3‐D kinematic motion capture were performed at initial presentation and approximately 8 weeks later. Force plate parameters evaluated included peak vertical force (PVF). Kinematic parameters measured included number of pelvic limb strides, stifle flexion and extension, maximum and minimum thoracic limb distance, truncal sway, and thoracic limb stride duration. Results Kinematic analysis showed that deviation of the spine to the right (truncal sway) was significantly smaller (P < .001) and the degree of right stifle flexion was significantly larger (P = .029) after treatment. Force plate analysis indicated that PVF was significantly different after treatment (P = .049) and the difference of the PVF also was significantly larger (P = .027). However, no correlation was found with either method of gait analysis and clinical recovery. Conclusions and Clinical Importance Kinetic and kinematic gait analysis were able to detect differences in dogs with CSM before and after treatment. A correlation of gait analysis to clinical improvement could not be determined.
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Affiliation(s)
- Kari D Foss
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, The University of Illinois Urbana-Champaign, Urbana, Illinois
| | - Rebecca L Smith
- Department of Pathobiology, College of Veterinary Medicine, The University of Illinois Urbana-Champaign, Urbana, Illinois
| | - Ronaldo C da Costa
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
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Cement plug technique for the management of disc-associated cervical spondylopathy in 52 Dobermann Pinscher dogs. Vet Comp Orthop Traumatol 2017; 29:195-201. [DOI: 10.3415/vcot-15-09-0160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/22/2016] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To report the radiographic and clinical outcome of an intervertebral bone cement plug technique for the management of disc-associated cervical spondylopathy in Dobermann Pinscher dogs.Methods: Retrospective study of 52 Dobermann Pinscher dogs.Results: A variable degree of cement plug subsidence with loss of vertebral distraction was evident in all dogs (n = 40) that were radiographed >6 weeks postoperatively. In no case was there definitive evidence of vertebral body fusion. Eight dogs had a sudden deterioration in neurological status, cervical hyperaesthesia, or both between three days and 12 weeks following surgery that was considered to be implant-associated; six of these dogs were euthanatized. Following surgery, 43/52 dogs were considered to be neurologically normal or to have improved, however, nine of 43 subsequently deteriorated due to adjacent segment disease. At the long-term follow-up, 34 dogs were considered to be neurologically normal or to have improved. Twenty-nine dogs were dead by the end of the study period.Clinical significance: Intervertebral bone cement plug surgery results in an initial improvement in clinical signs in the majority of Dobermann Pinschers with disc-associated cervical spondylopathy. However, it fails to maintain vertebral distraction or achieve vertebral body fusion, and is associated with acute implant complications, additional cervical disc protrusions or mortality in a significant proportion of cases.Online Supplementary Material: Please note that online supplementary material for this paper is available at: http://dx.doi.org/10.3415/VCOT-15-09-0160.
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Crawford AH, De Decker S. Clinical presentation and outcome of dogs treated medically or surgically for thoracolumbar intervertebral disc protrusion. Vet Rec 2017; 180:569. [PMID: 28283670 DOI: 10.1136/vr.103871] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 11/04/2022]
Abstract
To date, few studies have investigated the clinical characteristics of thoracolumbar intervertebral disc protrusion (IVDP). The aim of this retrospective study was to evaluate the presentation and outcome of dogs receiving medical or surgical treatment for thoracolumbar IVDP. Eighty-four dogs were included, with a median age of 9.4 years. German shepherd dogs and Staffordshire bull terriers were the most common breeds. Significantly more surgically treated dogs (n=53) had neurological deficits and were non-ambulatory, compared with medically treated (n=31). Outcome data were available for 27 of 31 medically managed dogs; 11 initially improved, 7 remained stable and 9 deteriorated. Of 18 dogs that initially improved or stabilised, 10 (55.6 per cent) demonstrated recurrence of clinical signs within 12 months of diagnosis. Outcome data were available for 45 of 50 surgically treated dogs that survived to hospital discharge; 34 improved, 9 remained stable and 2 deteriorated following surgery. Of 43 dogs that improved or stabilised with surgical treatment, 11 (25.6 per cent) demonstrated recurrence of clinical signs within 12 months of surgery. Overall, significantly more surgically treated dogs (71.1 per cent) had a successful outcome, consisting of sustained clinical improvement of more than 12 months duration, compared with medically treated dogs (29.6 per cent).
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Affiliation(s)
- A H Crawford
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
| | - S De Decker
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
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Provencher M, Habing A, Moore SA, Cook L, Phillips G, da Costa RC. Kinematic Magnetic Resonance Imaging for Evaluation of Disc-Associated Cervical Spondylomyelopathy in Doberman Pinschers. J Vet Intern Med 2016; 30:1121-8. [PMID: 27239003 PMCID: PMC5089627 DOI: 10.1111/jvim.13981] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/18/2016] [Accepted: 05/05/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The dynamic component of disc-associated cervical spondylomyelopathy (DA-CSM) currently is evaluated using traction magnetic resonance imaging (MRI), which does not assess changes in flexion and extension of the cervical vertebral column. In humans with cervical spondylotic myelopathy, kinematic MRI is used to identify dynamic compressions. HYPOTHESIS/OBJECTIVES To evaluate the feasibility and utility of kMRI in Doberman Pinschers with DA-CSM using a novel positioning device. We hypothesized that kMRI would identify compressive lesions not observed with neutral positioning and change the dimensions of the spinal cord and cervical vertebral canal. ANIMALS Nine client-owned Doberman Pinschers with DA-CSM. METHODS Prospective study. After standard MR imaging of the cervical spine confirmed DA-CSM, dogs were placed on a positioning device to allow imaging in flexion and extension. Morphologic and morphometric assessments were compared between neutral, flexion, and extension images. RESULTS Flexion was associated with improvement or resolution of spinal cord compression in 4/9 patients, whereas extension caused worsening of compressions in 6/9 patients. Extension identified 6 new compressive lesions and was significantly associated with dorsal and ventral compression at C5-C6 (P = .021) and C6-C7 (P = .031). A significant decrease in spinal cord height occurred at C6-C7 from neutral to extension (P = .003) and in vertebral canal height at C5-C6 and C6-C7 from neutral to extension (P = .011 and .017, respectively). CONCLUSIONS AND CLINICAL IMPORTANCE Our results suggest that kMRI is feasible and provides additional information beyond what is observed with neutral imaging, primarily when using extension views, in dogs with DA-CSM.
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Affiliation(s)
- M Provencher
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
| | - A Habing
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
| | - S A Moore
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
| | - L Cook
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
| | - G Phillips
- College of Veterinary Medicine and the Center for Biostatistics, The Ohio State University, Columbus, OH
| | - R C da Costa
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
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Gomes SA, Volk HA, Packer RM, Kenny PJ, Beltran E, De Decker S. CLINICAL AND MAGNETIC RESONANCE IMAGING CHARACTERISTICS OF THORACOLUMBAR INTERVERTEBRAL DISK EXTRUSIONS AND PROTRUSIONS IN LARGE BREED DOGS. Vet Radiol Ultrasound 2016; 57:417-26. [PMID: 27038182 DOI: 10.1111/vru.12359] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/17/2015] [Indexed: 12/01/2022] Open
Abstract
Treatment recommendations differ for dogs with intervertebral disk extrusion vs. intervertebral disk protrusion. The aim of this retrospective, cross-sectional study was to determine whether clinical and magnetic resonance imaging (MRI) variables could be used to predict a diagnosis of thoracolumbar intervertebral disk extrusion or protrusion in dogs. Dogs were included if they were large breed dogs, had an MRI study of the thoracolumbar or lumbar vertebral column, had undergone spinal surgery, and had the type of intervertebral disk herniation (intervertebral disk extrusion or protrusion) clearly stated in surgical reports. A veterinary neurologist unaware of surgical findings reviewed MRI studies and recorded number, location, degree of degeneration and morphology of intervertebral disks, presence of nuclear clefts, disk space narrowing, extent, localization and lateralization of herniated disk material, degree of spinal cord compression, intraparenchymal intensity changes, spondylosis deformans, spinal cord swelling, spinal cord atrophy, vertebral endplate changes, and presence of extradural hemorrhage. Ninety-five dogs were included in the sample. Multivariable statistical models indicated that longer duration of clinical signs (P = 0.01), midline instead of lateralized disk herniation (P = 0.007), and partial instead of complete disk degeneration (P = 0.01) were associated with a diagnosis of intervertebral disk protrusion. The presence of a single intervertebral herniation (P = 0.023) and dispersed intervertebral disk material not confined to the disk space (P = 0.06) made a diagnosis of intervertebral disk extrusion more likely. Findings from this study identified one clinical and four MRI variables that could potentially facilitate differentiating intervertebral disk extrusions from protrusions in dogs.
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Affiliation(s)
- Sergio A Gomes
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL97TA, Hatfield, UK
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL97TA, Hatfield, UK
| | - Rowena Ma Packer
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL97TA, Hatfield, UK
| | - Patrick J Kenny
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL97TA, Hatfield, UK
| | - Elsa Beltran
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL97TA, Hatfield, UK
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL97TA, Hatfield, UK
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Taylor-Brown FE, Cardy TJA, Liebel FX, Garosi L, Kenny PJ, Volk HA, De Decker S. Risk factors for early post-operative neurological deterioration in dogs undergoing a cervical dorsal laminectomy or hemilaminectomy: 100 cases (2002-2014). Vet J 2015; 206:327-31. [PMID: 26542365 DOI: 10.1016/j.tvjl.2015.10.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 09/28/2015] [Accepted: 10/04/2015] [Indexed: 11/26/2022]
Abstract
Early post-operative neurological deterioration is a well-known complication following dorsal cervical laminectomies and hemilaminectomies in dogs. This study aimed to evaluate potential risk factors for early post-operative neurological deterioration following these surgical procedures. Medical records of 100 dogs that had undergone a cervical dorsal laminectomy or hemilaminectomy between 2002 and 2014 were assessed retrospectively. Assessed variables included signalment, bodyweight, duration of clinical signs, neurological status before surgery, diagnosis, surgical site, type and extent of surgery and duration of procedure. Outcome measures were neurological status immediately following surgery and duration of hospitalisation. Univariate statistical analysis was performed to identify variables to be included in a multivariate model. Diagnoses included osseous associated cervical spondylomyelopathy (OACSM; n = 41), acute intervertebral disk extrusion (IVDE; 31), meningioma (11), spinal arachnoid diverticulum (10) and vertebral arch anomalies (7). Overall 54% (95% CI 45.25-64.75) of dogs were neurologically worse 48 h post-operatively. Multivariate statistical analysis identified four factors significantly related to early post-operative neurological outcome. Diagnoses of OACSM or meningioma were considered the strongest variables to predict early post-operative neurological deterioration, followed by higher (more severely affected) neurological grade before surgery and longer surgery time. This information can aid in the management of expectations of clinical staff and owners with dogs undergoing these surgical procedures.
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Affiliation(s)
- F E Taylor-Brown
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
| | - T J A Cardy
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
| | - F X Liebel
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion SG5 3HR, UK
| | - L Garosi
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion SG5 3HR, UK
| | - P J Kenny
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
| | - H A Volk
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
| | - S De Decker
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
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16
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De Decker S, Wawrzenski LA, Volk HA. Clinical signs and outcome of dogs treated medically for degenerative lumbosacral stenosis: 98 cases (2004–2012). J Am Vet Med Assoc 2014; 245:408-13. [DOI: 10.2460/javma.245.4.408] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Delamaide Gasper JA, Rylander H, Stenglein JL, Waller KR. Osseous-associated cervical spondylomyelopathy in dogs: 27 cases (2000–2012). J Am Vet Med Assoc 2014; 244:1309-18. [DOI: 10.2460/javma.244.11.1309] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lewis M, Olby NJ, Sharp NJH, Early P. Long-term effect of cervical distraction and stabilization on neurological status and imaging findings in giant breed dogs with cervical stenotic myelopathy. Vet Surg 2013; 42:701-9. [PMID: 23889830 DOI: 10.1111/j.1532-950x.2013.12034.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 06/15/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess long-term clinical and imaging outcomes in giant breed dogs with cervical stenotic myelopathy treated surgically. STUDY DESIGN Retrospective case series. ANIMALS Dogs (n = 7). METHODS All dogs had lateral or dorsolateral cord compression at 1 or more sites and were treated with cervical distraction and stabilization using PMMA plugs. Four dogs had follow-up CT or CT/myelography performed at least 6 months postoperatively. Spinal canal stenosis measurements were compared between pre- and postoperative CT images. Long-term clinical neurologic re-evaluation ranged from 4 to 7 years. Outcome was considered positive, satisfactory, or negative. Recurrence was defined as signs of a cervical myelopathy in dogs that initially improved or had stable disease postoperatively. RESULTS All dogs had immediate postoperative improvement. Recurrence (4 months to 4 years postoperatively) occurred in 3 dogs that had multiple sites of compression. Long-term outcome was positive in 4 of 7 dogs. Postoperative imaging revealed subjective regression of bony proliferation at surgical sites in 2 of 4 dogs that improved clinically but morphometric data showed no change in canal measurements. An adjacent site lesion was confirmed in 1 dog. CONCLUSIONS Distraction and stabilization with PMMA plugs and bone grafts is a safe surgical option for giant breed dogs with CSM with a single site of lateral or dorsolateral compression. Long-term recurrence was common among dogs with multiple sites of compression. Follow-up of 4 years or more among a larger population is indicated to fully assess implications of surgical intervention and determine recurrence rates.
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Affiliation(s)
- Melissa Lewis
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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De Decker S, da Costa RC, Volk HA, Van Ham LML. Current insights and controversies in the pathogenesis and diagnosis of disc-associated cervical spondylomyelopathy in dogs. Vet Rec 2012. [DOI: 10.1136/vr.e7952] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- S. De Decker
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - R. C. da Costa
- College of Veterinary Medicine; The Ohio State University; 1900 Coffey Road Columbus OH 43210 USA
| | - H. A. Volk
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - L. M. L. Van Ham
- Faculty of Veterinary Medicine; Ghent University; Salisbrylaan, 133 B-9820 Merelbeke Belgium
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Letters to the Editor. J Am Vet Med Assoc 2012; 240:1410; author reply 1410. [DOI: 10.2460/javma.240.12.1410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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