Chapter 27-37

Question 1

Foss JFMS 21
cutaneous truncii in normal cats

Answer 1

80% unilateral
98% bilateral

Question 2

Fastener JFMS 20
cutaneous truncii in abnormal cats

Answer 2

65% of cats
spinal pain assoc with reflex being present

Question 3

Mella JFMS 20
feline spinal disease

Answer 3

middle aged purebred - IVDD
older cats - ischemic myelopathy
young cats - fx/luxation

Question 4

Craciun VCOT 22
Contrast enhanced MRI for IVDE

Answer 4

Gandolium can aid in surgical planning and improve confidence of level of location/extent of extradural material

Question 5

Tam VRU 22
Vertebral OSA on MRI

Answer 5

has T2 signal heterogeneity, contrast enhancement, and osteolysis on MRI
Contrast enhancement was typically strong and heterogeneous.

Question 6

Ros JAVMA 22
central cord syndrome

Answer 6

● “central cord syndrome” = clinical presentation where patients show more severe paresis in TL than PL
● 2 locations for central cord syndrome were identified: C1-C5 (90% of the time) and C6-T2 (10%)
● not a negative prognostic

Question 7

Nakamoto VS 21
myelomalacia with/without extensive hemi

Answer 7

Survival rate was higher in the extensive hemilaminectomy and durotomy group (100% survival) than standard hemilaminectomy (65% survival)

Question 8

Trouble JVIM 21
Brachial plexus injury

Answer 8

● evaluated compound muscle action potential (CMAP) for return to function
● CMAP was higher in cases that had clinical improvement (4.3 mV vs 0 mV)
● Threshold CMAP >5 mV prognostic for recovery

Question 9

Lueck JVIM 22
Trazodone administration

Answer 9

• Seven of 32 (22%) dogs had worse scores on their neurologic examination after receiving trazodone, manifesting as new or progressive PR deficits.
  o 18.7% of the dogs had consciousness levels that changed from bright, alert, responsive to quiet, alert, responsive after trazodone administration.
  o No other changes were observed on neurologic examination.
• Sedation and anxiety scores were significantly different after trazodone administration compared to before
• Most dogs did not have changes on neurologic examination after trazodone administration. However, approximately 20% of dogs had new or worsening PR deficits after receiving trazodone. Ideally, trazodone should not be given before neurologic examination in dogs.

Question 10

Kent JAVMA 19
meningovertebral ligament in dogs

Answer 10

● all dogs had a meningovertebral ligament, which formed the ventral boundary of the epidural space and consisted of fibrous bands that attached the ventral dura mater to the dorsal surface of vertebral bodies
● pathologic structures ventral to the spinal cord adopted a bilobed shape

Question 11

Cameron JVECC 20
dogs/cats in TBI

Answer 11

● In dogs, nonsurvivors had higher glucose (150 vs 120 mg/dL)–> not in cats
● Modified glasgow coma score was predictive for survivors (higher = better)

Question 12

Knight JFMS 19
Feline head trauma

Answer 12

● 90% of cases had multiple bones of the skull fractured
● TMJ injury occurred in 60%
● increasing age at presentation and presence of internal upper jaw fractures were risk factors for development of complications
● no risk factors for mortality

Question 13

Caine JFMS 19
TRI and MRI

Answer 13

● negative outcome in TBI cases with peripharyngeal pattern of injury and orbital trauma

Question 14

Gomes JFMS 22
Discospondilitis in cats

Answer 14

● all cats presented with spinal hyperesthesia
● Neuro dysfunction seen in 60%
● positive bacterial urine cultures in 11%
● excellent outcome in 85% with conservative management

Question 15

Kristiansen VCOT 22
Nucleus pulposus extrusion in dogs

Answer 15

● thoracolumbar hydrated nucleus pulposus extrusion was more often painful and extruded disc material was more often lateralized
● TL HNPE were more commonly compressive, more often received surgery
● No difference in outcome between cervical and TL HNPE or conservative vs surgical treatment

Question 16

Trub JVIM 21
C-reactive protein in disco in dogs

Answer 16

• Serum CRP concentration was significantly more sensitive than were fever and leukocytosis for predicting the presence of diskospondylitis.
• Serum CRP concentration was more sensitive than neutrophilia and hyperglobulinemia. No difference in serum CRP concentration was found between dogs with single or multiple lesions,
• nor between dogs with or without empyema, muscular involvement or spinal cord compression.
• No association was found between serum CRP concentration and positive bacterial culture
• C-reactive protein is a sensitive, but non-specific biomarker for diskospondylitis which may prove useful as an adjunctive diagnostic test in patients with suspicious clinical signs and may help predict prognosis.

Question 17

Gomes JVIM 22
CT features in disco in dogs

Answer 17

• The most frequently found changes were: (1) endplate involvement (87.3%) most frequently bilateral (94.5%), with erosion (61.9%) and multifocal osteolysis (67.3%); (2) periosteal proliferation adjacent to the IVDS (73%) and spondylosis (66.7%); and (3) vertebral body involvement (66.7%) involving one-third of the vertebra (85.7%) with multifocal osteolysis (73.5%). Other less prevalent features included an abnormal IVDS (narrowed or collapsed), sclerosis of the adjacent vertebral body or endplates, presence of disseminated idiopathic skeletal hyperostosis or vacuum artifact.
• We determined that bilateral endplate erosion and periosteal proliferation were very common in dogs with discospondylitis. Careful evaluation of CT in all 3 planes (dorsal, sagittal, transverse) is necessary to identify an affected IVDS. These described CT features can aid in the diagnosis of discospondyli- tis in dogs but equivocal cases might still require MRI.

Question 18

West JVIM 23
Non traumatic hemorrhaging myelopathy in dogs

Answer 18

• Non-traumatic spinal cord hemorrhage (NTSH) is an uncommon cause of myelopathy in dogs.
• The onset of signs was acute and progressive in 70% of cases; spinal hyperesthesia was variable (48%).
• Hemorrhage was identified in the thoracolumbar spinal segments in 65% of dogs. An underlying cause was identified in 65% of cases.
• Overall, 64% of dogs had a good or excellent outcome, regardless of cause; which was increased to 100% for SRMA, 75% for A. vasorum and 75% for idiopathic NTSH.
• Outcome was not associated with neurological severity. Recovery rate was 67% and 50% for nociception-intact and nociception-negative dogs, respectively.

Question 19

Bourbon VRU 23

Answer 19

• Anecdotally, during the review of CT and MRI studies of canine patients including the cranial cervical spine, authors have identified a small osseous structure between the atlas (C1) and axis (C2) with no relevant clinical signs. This structure appeared comparable to a “persistent ossiculum terminale” in humans.
• Mean age was 85 months (6–166) and breed variation was present.
• A total of 20 imaging studies were evaluated: CT was performed in 17 dogs; MRI in three dogs; two dogs had both MRI and CT performed. In all cases the presence of at least one small osseous body on the cranial aspect of the odontoid process compatible with a persistent ossiculum terminale was identified as a possible incidental finding without any overt clinical implications.
• Findings indicated that a small osseous body on the cranial aspect of the odontoid process (presumed persistent ossiculum terminale) in CT and MRI studies may be present in dogs with no clinical signs of neurologic disease.

Question 20

Planchamp VS 22
CT and MRI cutoff for AA

Answer 20

● cutoff values for ventral compression index >0.16 in extended and > 0.2 in flexed positions were diagnostic for atlantoaxial instability with >95% sensitivity

Question 21

Planchamp VS 22
Head position for AA

Answer 21

● all transarticular imaging measurements were dependent on head neck position
● recommended a standardized head neck position of 50 degrees flexion

Question 22

White VE 19
angles for AA

Answer 22

● when flexed lateral radiographs were evaluated with a cutoff value for atlas-to-axis angle >10, evaluation of all breeds revealed a 90% sensitivity and specificity
● recommended 50 flexed lateral views, with AA instability diagnosed if atlas-to-axis angle >10*
● AAA: angle obtained by drawing intersecting lines between roof of C1 and roof of C2

Question 23

Leblond VCOT 18
trans articular screw vs PMMA AA

Answer 23

● Transarticular screw – achieved better apposition than cemented constructs
● Overall, 5% of screws were in dangerous position
● PMMA group were less prone to failure when mechanically tested

Question 24

Toni JSAP 20
AA stabilization with bicortical screws

Answer 24

● stabilized using screws and PMMA
● 93% of screws were placed fully within the pedicle; 7% breached medial pedicle wall
● adverse events in 5/12
● 2/12 died postop; 80% of survivors had improvement in Modified Frankel score

Question 25

Waschk VCOT 18
anomalies in AA

Answer 25

● only dogs with atlantoaxial instability had dens axis anomalies such as separation or abnormal conformation
● patients with AAI were more likely to have other craniovertebral junction abnormalities

Question 26

Hamilton-Bennet VS 18
3D printed guide for AA

Answer 26

● worked well… used to stabilize caudal cervical instability/fracture; screws placed from ventral
● minor vertebral canal breach in 9%

Question 27

Argent JSAP 22
recurrent with cervical IVDE

Answer 27

● 30% success with cervical IVDH treated conservatively
● 70% success with cervical IVDH treated surgically
● recurrence of signs in 34% (⅔ of these cases were initially treated conservatively)
● following surgical cases, recurrence of signs was mostly due to disc extrusion at an IVD site adjacent to initial surgery, not at the same site
● rate of recurrence not different between cases managed conservatively and surgically

Question 28

Olender JAVMA 23
cervical jerk

Answer 28

• Jerks all presented as focal repetitive rhythmic contractions on the lateral aspect of the neck (on one or both sides).
• All dogs had a diagnosis of cervical intervertebral disk extrusion (IVDE), half of them at the C2-C3 level. No dogs presented with extrusion caudal to the C4-C5 interverte- bral disk space.
• Cervical jerk associated with cervical pain or myelopathy may represent myoclonus and was exclusively secondary to cranial cervical IVDE in this study. Full recovery was observed following medical or surgical treatment of IVDE. The exact origin and classification of this involuntary movement has yet to be established.

Question 29

Murthy JVIM 23
horners syndrome in cervical myelopathy

Answer 29

• Non-compressive disease occurred more frequently in the Horner group compared with controls
  o The most common diseases were fibrocartilaginous embolism in the Horner group and intervertebral disc extrusion amongst controls.
• On MRI, parenchymal hyperintensity was seen more commonly in the Horner group compared with controls
• In the Horner group, dogs that did not survive to discharge had more extensive MRI lesions relative to the adjacent vertebral length compared with survivors
• Lateralization of Horner signs and MRI changes matched in 54% of cases.
• The overall survival rate was high in both Horner (80/93; 86%) and control (95/99; 96%) groups.
• Horner syndrome in cervical myelopathy is commonly associated with noncompressive intraparenchymal disease.

Question 30

Albuquerque Bonelli VRU 21
neurologic signs with MRI

Answer 30

● 25% large breed; 75% giant breed
● male predilection
● Dogs with multiple site of compression associated with higher severity of compression and foraminal stenosis
● disc degeneration in 80T of cases
● No age association with severity of compression

Question 31

Bonelli JAVMA 19
GSD MRI findings with cervical CSM

Answer 31

● 90% male
● 90% chronic signs
● osseous proliferation of the articular processes was seen in 60%
● 80% also had ligamentum flavum (yellow ligament) hypertrophy

Question 32

Reints VS 19
cervical fusion for caudal CSM

Answer 32

● Used the SynCage spacer then stabilized using two Unilock plates
● pain and neuro scores improved in all dogs
● implant failure in 45%
● Adjacent site pathology in 78% (not clinical)
● ~80% bone ingrowth seen

Question 33

Nye JVIM 20
long term follow up with osseous CSM

Answer 33

● of sites with stenosis, 45% unchanged, 20% improved, and 40% worsened
● long-term follow did not identify clinical or MRI progression of lesions in the majority of dogs

Question 34

Albuquerque Bonelli JVIM 23

Answer 34

● 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).
● 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.

Question 35

Mateo VS 20
ventral access to cd cervical/cr thoracic

Answer 35

● median manubriotomy improved surgical access to the ventral aspect of caudal cervical and cranial thoracic spine without, can be considered in ventral decompression or stabilization cases

Question 36

Schmidli VCOT 18
2nd cervical fx

Answer 36

● variable severity of neuro signs (cervical pain to tetraparesis)
● 80% had recovery without persistent neuro signs (good recovery seen with both surgical and conservatively managed cases
● low perioperative mortality

Question 37

Dyall VCOT 18
SSI and hemi

Answer 37

● overall SSI rate 0.6%
● no dogs received perioperative ABX

Question 38

Zidan JVIM 20
long term PO pain from hemi

Answer 38

● sensory thresholds at the surgery site normalize by 6 months after surgery
● 15% of dogs with spinal cord damage may develop chronic neuropathic pain

Question 39

Fenn JVIM 20
anesthesia and IVDE

Answer 39

● all dogs had paraplegia with absent pain perception
● confirmed a negative association between increased duration of anesthesia (and surgery) and outcome

Question 40

Jeffery VS 20
extended durotomy for IVDE

Answer 40

● all dogs (24) paraplegic, deep pain-negative
● performed four-vertebral body length durotomy centered on herniated disc
● No detrimental effects of durotomy - “extended durotomy appears safe and may improve outcome of dogs with severe TL contusion and compression
● 67% recovery of neuro status

Question 41

Takahashi VS 20
durotomy with IVDE

Answer 41

● percentage of dogs regaining ambulation was better in the durotomy group (57%) than standard hemilaminectomy group (39%)
● No dogs in durotomy group died of myelomalacia; ~20% of hemilaminectomy dogs died of myelomalacia
● performing durotomy in combination with decompression improved return to function and prevented myelomalacia

Question 42

Gordon-Evans VS 19
BCS and recovery

Answer 42

● increased disability index (i.e. more severe neuro signs) score was associated with increased risk of slow postoperative recovery
● BCS, and age not prognostic
● on average, dogs lost weight and body fat but gained muscle mass with rehab

Question 43

Mojarradi JSAP 21
hydrotherapy and hemis

Answer 43

● “hydrotherapy is unlikely associated with occurrence of postoperative complications”

Question 44

Woelfel VS 21
extensive epidural hemorrhage

Answer 44

● recovery of ambulation in 78% of dogs with pain perception and 40% of dogs without pain perception
○ normally, intact pain with plegia has 90% recovery; loss of pain perception has 60% recovery
● progressive myelomalacia in 5%
● prognostic factors for outcome: loss of pain perception/clinical severity, number of vertebra with signal interruption, and ratio of vertebral sites decompressed to number of vertebrae with signal interruption
● dogs with extensive epidural hemorrhage have a less favorable outcome after surgical decompression than standard IVDE paraplegic dogs
● more extensive decompression improcomes

Question 45

Johnson JVIM 22
hydromelia and IVDE

Answer 45

● hydromyelia was identified at sites of IVDE in 84/91 dogs
● absence of hydromyellia was associated with longer duration of clinical signs
● MRI finding of hydromyelia might be a predictor of lesion chronicity
● hydromyelia = distention of central canal
● syringohydromyelia = cavity formation within the spinal accord parenchyma

Question 46

Schueler JSAP 18
lipase and IVDE

Answer 46

● serum canine pancreatic lipase was increased in dogs with IVDE

Question 47

Martin JSAP 20
surgery time and IVDE

Answer 47

overnight delay before spinal decision increases the risk of clinically meaningful deterioration in dogs unable to walk following TL disc extrusion

Question 48

Upchurch VCOT 20
surgery time and IVDE

Answer 48

● duration of clinical signs prior to surgery and rate of onset of signs did not correlate with return of pain sensation, urinary continence, or ambulation
● preoperative neuro grade was main variable that was associated with outcome (shocking)
● delay from clinical signs to surgery is unlikely to affect outcome

Question 49

Dongaonkar VS 21
irrigation

Answer 49

● intermittent bolus irrigation was associated with lower peak vertebral canal temperatures than continuous irrigation, but both were effective

Question 50

Tirrito JAVMA 20
surgeon perception

Answer 50

● Median spinal cord compression preop 45%, 9% postop
● surgeon’s perception of adequate spinal cord decompression may be less reliable
● Unsatisfactory spinal cord decompression seen with increased severity of preop neurologic grade, preoperative compression, and TL discs

Question 51

Hodshon JAVMA 18
transient pelvic limb reflexes with TL myelopathy

Answer 51

● 20% of the time dogs with TL spinal cord lesions can develop transient depression of PL reflexes (may influence neuroanatomic localization)

Question 52

Bravo JSAP 19
lidocaine patch

Answer 52

● 5% lidocaine patches did not provide additional postoperative analgesia in dogs undergoing hemilaminectomy

Question 53

Schmierer VS 20
pregabalin

Answer 53

● pregabalin reduced pain levels rather than opioids alone

Question 54

Skytte JAVMA 18
neuro score and micturition/ambulation

Answer 54

● mean interval from surgery to regain micturition was 4 days
● mean time to regain ambulation was 13 days
● significant negative correlation with severity of signs/modified frankel score for both urination and ambulation

Question 55

Harris VCOT 20
Fenestration leads to new disc material %

Answer 55

33

Question 56

Hall VCOT 21
practice of fenestration

Answer 56

● fewer surgeons (55%) than neurologists (82%) fenestrated

Question 57

Irizarry VS 22
Percutaneous laser disc ablatino

Answer 57

● there were no disc extrusion or spinal cord lesions identified
● lesions were more common in the caudal endplates of the disc space

Question 58

Kerr JSAP 21
IVDE and Frenchies

Answer 58

● 51% of frenchies that had decompressive surgery for TL or cervical IVDE had recurrence of signs
● median time between decompressive surgery and recurrence 10 months
● didn’t mention if they recurred at the same or different spaces

Question 59

Longo JVIM 21
recurrence from sx treated IVDE

Answer 59

● clinical signs recurred in 36%
● finding a completely degenerate disc in T10-L3 region at the time of initial surgery was associated with hazard ratio of 3 for recurrence of clinical signs

Question 60

Paran JSAP 23
GER in dogs undergoing MRI for TL pathology

Answer 60

• Fifty percent (95% confidence interval: 45 to 57%) of included dogs had evidence of gastroesophageal reflux.
  o Reflux was not associated with the individual breed, age, sex, neuter
  status or body weight.
• Brachycephalic dogs did not demonstrate significantly higher rates of reflux compared to non-brachycephalic dogs.
  o A larger volume of reflux was associated with a higher chance of regurgitation.
• Gastroesophageal reflux is a common finding in dogs undergoing thoracolum-
  bar spine magnetic resonance imaging. Dogs which regurgitated had higher volumes of reflux. Early detection and quantification of the volume of reflux is helpful as it may allow the anaesthetist to take measures which may reduce the risk of associated complications.

Question 61

Aikawa JSAP 22
vertebral stabilization for instability in pugs

Answer 61

• Seven dogs were presented with ambulatory or non-ambulatory paraparesis. Caudal articular process anomalies (three dogs) and concomitant cranial and caudal articular process anomalies (four dogs) were noted.
• Myelography (six dogs) or magnetic resonance imaging (one dog) showed none to severe spinal cord compression.
• These dynamic compressions were located at sites with articular process anomalies (seven sites) and sites with no articular process anomalies (two sites).
• Vertebral instability was confirmed by intraopera- tive spinal manipulation in all dogs.
• Dynamic myelography and/or intraoperative spinal manipulation demonstrated vertebral instabilities at sites with or without articular process anomalies on imaging. Decompressive laminectomy with vertebral stabilisation resulted in long-term neurological improvement in most dogs.

Question 62

Sakaguchi JAVMA 2023
extruded material and near status

Answer 62

• Weak positive correlation was found between the volume of the extruded materials into the vertebral canal and the grade of neurologic severity.

Question 63

Siu JAVMA 23
bacteriuria in dogs following IVDE sx

Answer 63

Clinical signs of bacteriuria may be limited to new-onset urinary incontinence, inappropriate urination, or both. Delaying antimicrobial treatment until clinical signs of bacteriuria developed did not result in adverse conse- quences or systemic illness

Question 64

Silva JAVMA 23
Frenchie cervical vs TL region

Answer 64

• The epidural space did not appear to be larger in the cervical than in the thoracolumbar region in this population of French Bulldogs, contrary to previous reports.

Question 65

Bridges JVIM 22
TL disc assoc epidural hemorrhage in dogs

Answer 65

• Sixty-three of 160 (39%) dogs had confirmed EH. French Bulldogs were sig- nificantly overrepresented
• Dogs with EH were more likely to present with clinical signs less than 48 hours than were dogs without EH and were more likely to be nonambulatory on pre- sentation
• Dogs with EH were more likely to have <50% cross-sectional spinal cord compression than dogs without EH, longer longitudinal spinal cord compression (3 spaces vs 1 space, P < .001), and greater intrinsic spinal cord change (grade 3/severe vs grade 1/mild; P < .001) based on MRI.
• The location of the intervertebral disc herniation in French Bulldogs with EH was more likely to be thoracolumbar

Question 66

Lovell JVIM 22
fentanyl or ketamine-dex PO spinal sx

Answer 66

• No difference was found in time to recovery of ambulation between groups or in pain scores. Differences in time to recovery of eating and urination were small but favored ketamine- dexmedetomidine
• There was no evidence that, at the doses used, fentanyl impaired ambulatory outcome after surgery for thoracolumbar intervertebral disc herniation in dogs. Pain control appeared similar between groups.

Question 67

Wachowiak JVIM 22
TL myelopathy in pugs

Answer 67

• Magnetic resonance imaging revealed 3 dogs with Constrictive myelopathy (CM)only, 17 with CM plus at least 1 other myelopathy, 11 dogs with non-CM myelopathies only, and 1 with no MRI abnormalities.
  o Nineteen of 32 dogs had >1 myelopathy diagnosis on MRI whereas 15/32 had >1 site of spinal cord compression. All dogs had CAPD at >1 site in the T3-L3 vertebral column on CT.
• Constrictive myelopathy affected more than half of pug dogs presenting with chronic thoracolumbar myelopathies. Most had multilevel disease, concurrent myelopathies, or both. There was no apparent relationship between anatomic locations of CAPD and most severe myelopathy or myelopathy type.

Question 68

Mehra JVIM 23
Omeprazole for IVDE

Answer 68

• Gastrointestinal signs developed in 10/20 (50%) dogs in the omeprazole group and in 7/17 (41%) dogs in the placebo group (P = .59).
  o Diarrhea was common (8/20 omeprazole, 5/17 placebo), hematochezia was rare (1/20 omeprazole, 1/17 placebo); melena was not observed.
  o Clinicopathologic evidence suggestive of bleed- ing was present in 9/20 dogs treated with omeprazole and in 11/17 dogs that received placebo (P = .23).
  o Fecal occult blood positivity was more common in dogs with GI signs (P = .03).
• Short-term, prophylactic omeprazole treatment did not decrease clinically detectable GI complications in dogs with acute TL-IVDE.

Question 69

Peschard VRU 23
MRI in dogs with ongoing/recurrent neurological symptoms after sx

Answer 69

• Reherniation and reoperation rates of 4.5%–36% are reported in canine patients treated for intervertebral disc herniation (IVDH).
• Chondrodystrophic breeds, specifically Dachshunds, overrepresented.
• Mean number of days between surgery and second MRI was 335. use of MRI as a diagnostic modality for spinal imaging following IVDH surgery
• In 11 cases, spinal cord compression suspected to be clinically significant was found at the surgical site; the extradural compressive material consisted of intervertebral disc material only, or a combination of intervertebral disc material and hematoma or inflammatory changes in 10 cases, and a displaced articu- lar process and fibrous tissue in one case. The latter is a newly described complication of mini-hemilaminectomies.

Question 70

Cordle VRU 23
MRI confirmation of PMM

Answer 70

• Length of T2-weighted hyperintense spinal cord change and HASTE signal loss were significantly associated with clinically evident, however, there were no significant differences between groups when analysis was restricted to dogs not yet showing clinical signs of PMM.
• The PMM group also had significantly shorter compressive lesions than the control group, suggesting a possible role of more severe focal pressure at the extrusion site. A segment of total loss of contrast enhancement in the venous sinuses and meninges, a feature not previously described, was more common in the PMM group and the difference approached significance

Question 71

Zanoguerra JSAP 23
surgical timing with deep pain negative TL IVDE

Answer 71

not associated with rapidity of recovery
duration and neurologic grade at presentation significantly assoc with recovery

Question 72

Crawford VCOT 18
hemilam with either anulectomy or partial discectomy

Answer 72

● Hemi + partial discectomy >annulectomy; significantly increased clinical improvement

Question 73

Fowler JFMS 22
Surgical outcomes in cat TL IVDD

Answer 73

● 60% presented with L4-S3 lesion
● most common site was L6-7 (33%)
● 90% positive outcome with surgery
● no association was identified between severity of disease and clinical outcome

Question 74

Bibbiani JFMS 22
IVDH in cats

Answer 74

• Most common type of IVDH was ANNPE (n = 22), followed by IVDP (n = 19) and IVDE (n = 9).
  o Cats with a single IVDH were statistically significantly associated with a diagnosis of ANNPE (P = 0.023) compared with cats with multiple IVDHs affected by IVDP (P = 0.004).
• Neuroanatomical localisation included L4–S3 (n = 19/43), T3–L3 (n = 18/43) and C1–C5 (n = 6/43). Males were more commonly affected by IVDE (P = 0.020) and females by ANNPE (P = 0.020).
• Cats with IVDP had a longer duration of clinical signs (P <0.001) than cats with ANNPE and demonstrated milder neurological deficits (P = 0.005).
• IVDEs were statistically significantly associated with spinal hyperaesthesia (P=0.013), while ANNPEs were not (P=0.014).

Question 75

Mathiesen VS 18
ventral stabilization of thoracic kyphosis through intercostal thoracotomies

Answer 75

● all dogs undergoing vertebral stabilization using SOP placement experienced a good outcome
● one lung lobe laceration, 2 seromas (6 dogs in study)

Question 76

COnte VCOT 20
thoracic vertebral canal stenosis in brachy

Answer 76

● cranial thoracic vertebral canal stenosis is observe most commonly in young, male bulldogs
● stenosis ratio of 0.56 had 67% sensitivity to differentiate between dogs with and without neuro signs

Question 77

Wyatt JAVMA 18
nonsx treatment of thoracic vertebral body malformations

Answer 77

● all dogs screw-tail brachy dogs
● all dogs had ambulatory paraparesis and ataxia; all cases progressed
● nonsurgical treatment of congenital thoracic vertebral body malformations was associated with unfavorable outcome

Question 78

Gluding JSAP 21
Genetic background of LS transitional vertebrae in GSD

Answer 78

moderate heritability

Question 79

Inness VCOT 21
distraction stabilization for LS dtenosis

Answer 79

● technique: dorsal laminectomy, annulectomy, and distraction-stabilization with pins and PMMA
● 95% of cases were due to disc protrusion; 75% had sclerosis of caudal end-plate of L7
● 85% had improved function; 100% improved pain postop
● mean LS step defect reduced 60%, mean foraminal width increased 50%

Question 80

Lichtenhahn Vet Surg 20
Evaluation of L7-S1 nerve root pathology with MR

Answer 80

● loss of foraminal fat signal was seen in 75% of cases
● loss of foraminal fat signal associated wtih L7 radiculopathy and foraminal stenosis
● unilateral lesions associated with clinical sings on ipsilateral limb

Question 81

TOni VCOT 20
Accuracy of pedicle screw placement in LS

Answer 81

● 30/32 screws were fully within pedicle

Question 82

Zindl VS 18
novel pedicle screw-rod fixation in LS joint

Answer 82

● compared to intact , laminectomy resulted in increase in angular displacement at L6-7 and L7-1
● pedicle screw-rod fixation system resulted in a significantly reduced motion at L7-1 with a concomitant increase at adjacent level (L6-7) → ADJACENT SEGMENT SYNDROME/DOMINO EFFECT

Question 83

Saunders VS 18
rostral projection of sacral lamina in LS stenosis

Answer 83

● The sacral lamina did not extend as far rostrally in affected dogs, compared to unaffected dogs
● Rostral projection of the sacral lamina, previously proposed as a potential risk factor in dogs with CES due to lumbosacral degeneration, was not associated with a diagnosis of DLSS in this study; the opposite was true.

Question 84

Worth VCOT 18
lateral foraminotomy

Answer 84

● 5/6 successful outcome with foraminotomy 🡪 alleviation of pain and increased activity level
● 650-800% increase in volume of the intervertebral foramen following surgery (osseous regrowth at foramen reduced foramen volume ~50%)
● achieved persistent enlargement of foramen 24 months PO, however, osseous regrowth at site may limit effectiveness longer term 🡪 repeat sx may be necessary

Question 85

Garcia VS 21
cats with urine retention after sacrocaudal lux

Answer 85

● 100% cats recovered normal micturition spontaneously within 50 days
● long-term cystostomy was effective at managing urinary retention post-sacrocaudal luxation

Question 86

Muniz VS 20
bulldogs with spinal LS

Answer 86

● presenting complaint urinary and fecal incontinence in 100%
● dorsal laminectomy in all do for removal of meningeal sac
● postoperative urinary and fecal incontinence improved in 33%, paraparesis improved in ⅔

Question 87

Bresciani VS 21
LS IVDE in dogs

Answer 87

● 7/13 neuro signs, all presented for pain with nerve root signature
● MRI revealed lateralized herniated disc material in all cases
● excellent outcome in 85% treated with dorsal laminectomy

Question 88

Franklin JSAP 23
sacro-coccygeal IVDE

Answer 88

• This is the first report of a sacrococcygeal disc extrusion resulting in faecal incontinence, with successful surgical management.

Question 89

Tanoue JAVMA 22
PO outcomes on dorsal lam with transarticular screws, pedicle screws, and PMMA

Answer 89

• In all 21 cases, clinical signs were alleviated, proprioceptive deficits were improved from 3 months after surgery, and no recurrence of clinical signs was observed during the observation period.
• Minor complications were observed in 6 cases (28.6%), including implant failure in 2 (9.5%), delayed healing of surgical wounds in 2 (9.5%), seroma in 1 (4.8%), and swelling of the affected area in 1 (4.8%).
• There was no case with major complications.

Question 90

Santifort VRU 22
3D MRI angiography

Answer 90

• Overall, the results of this study show that fast 3D CE-MRA of the lum- bar region in dogs is feasible. However, the smaller arteries responsible for the spinal cord vascular supply were not visualized in this study.

Question 91

McBride JVIM 22
spinal shock injury

Answer 91

● background: loss of PL reflexes indicates L4-S3 lesion; however, could also indicate T3-L3 myelopathy with concurrent spinal shock
● odds of spinal shock decreased with increasing weight, increasing duration of clinical signs, decreased pelvic limb tone
● odds of spinal shock increased when paraplegia

Question 92

Schmitt VS 21
CT of proposed implant corridors

Answer 92

● vertebral corridors ranged from 3.8-5.2 mm; widest at T1
● Ideal angles: T1 38, T2 32, T3-T9 25*
● dorsal approach for T1-T4 would be challenging due to variability found in these vertebrae
● less variability in vertebrae T5-T9, more amenable to dorsal approach

Question 93

Samer VCOT 21
accuracy of freehand pin placement

Answer 93

● mean deviation in angle 8*
● most deviations in position were lateral and caudal

Question 94

Woelfel VS 22
cervical locked facets

Answer 94

● all dogs small or toy breed dogs with trauma
● relatively severe clinical signs (tetraparesis, tetraplegia)
● only sites of occurrence were C5-6, and C6-7
● all dogs had unilateral dorsal displacement of the cranial articular process of the caudal vertebra relative to the caudal process of cranial vertebra
● 100% ambulatory
● “locked facet” injury should be differential for small or toy-breed dogs with cervical myelopathy secondary to trauma

Question 95

Lewchalermwong VCOT 18
vertebral screw and Rox fixation

Answer 95

● New canine vertebral screw and rod fixation (CVSRF) performed better than screw-PMMA in all tests

Question 96

Segal JSAP 18
LS fx repair with SOP

Answer 96

● bilateral twisted SOP can be associated with satisfactory result in treating lumbosacral fracture-luxation

Question 97

Couper JFMS 20
urinary and defecatory fx in cats from sacrocaud lux

Answer 97

● 90% regained voluntary urinary function
● higher neuro grade associated with decreased likelihood and longer duration of regaining urinary function
● neurologic grade is most important prognostic factor in cats with sacrocaudal luxation (tail pull injury)

Question 98

Caraty JSAP 18
stabilization for tail avulsion in cats

Answer 98

● tail reconstruction performed with 2 nylon sutures
○ drilled hole in dorsal spinous process of sacrum; passed nylon suture around transverse process of caudal vertebra and through drill hole, then tied; repeated on other side
● 50% urinary incontinent at surgery (60% regained continence within 1 month)
● 75% of cats regained tail function and pain sensation postop

Question 99

Elford VS 20
pedicle screw in TL spine in dogs with defects

Answer 99

● 5% partial penetration of medial pedicle wall

Question 100

Muller VCOT 22
musculature in dogs with/without AA

Answer 100

Dogs with AAI showed a significantly lower dorsal-to-ventral muscle-area ratios (d-v-ratio) at levels 2 and 3, d-C2- ratio at level 2 and ratio of moments at all levels.

Question 101

Amengual-Batle JVIM 20
traumatic skull fx

Answer 101

● dogs - more commonly had fracture of cranial vault
● cats - more commonly had fractures of face and base of cranium
● cats = multiple fractures
● cranial vault fractures = more likely to develop neuro signs, more likely to die

Question 102

Farkle JVIM 20
seizures with hydrocephalus

Answer 102

● seizure prevalence in dogs and cats with internal hydrocephalus was low (2%)
● seizures were not observed in the 2 year period after surgery
● seizures do not appear to be a complication associated with ventriculoperiitoneal shunt

Question 103

Gillespie JAVMA 19
pred vs sx for hydrocephalus

Answer 103

● of the cases treated with prednisone, 50% improved, 50% deteriorated
● of surgical cases, 55% improved

Question 104

Parker JVIM 22
seizure after rostrotentorial surgery

Answer 104

● dogs with rostrotentorial brain times had early postop seizures in 13% of cases
● perioperative anticonvulsant not associated with postoperative seizures
● seizures postop = more likely to have neuro complications, less likely to survive

Question 105

Kohler JAVMA 18
risk factors for dogs undergoing brain sx

Answer 105

● 13% died and 20% developed major complications within 30 days of surgery
● dogs with abnormal preop neuro exam were more likely to develop complications or die
● suboccipital approach were more likely to die

Question 106

Forward VS 18
PO comps after brain sx

Answer 106

● early postoperative neuro deterioration seen in 45% (got worse before getting better)
● postoperative complication in 50%
● 90% survival to discharge
● higher postoperative natremia and prolonged hospitalization were associated with postoperative complications

Question 107

Morton JAVMA 22
complications after brain sx

Answer 107

● complications in 50% within 10 days
● most common complications postop were neurologic deficits, seizures, and aspiration pneumonia
● 15% short term mortality rate
● long-term complications in 40% (seizures or neuro deficits)

Question 108

Hyde VS 23
Pituitary masses

Answer 108

• The majority of dogs presented for mentation change (12/15).
• The mean pituitary to brain ratio (P/B ratio) was 1.05 (0.6–1.4).
• Eleven dogs were diagnosed with a non- functional pituitary adenoma (NFPA).
• Perioperative mortality was 33% (5/15). The median survival for all dogs was 232 days (0–1658). When dogs that did not survive to discharge were excluded, the median survival time was 708 days.
• Seven of 10 dogs that survived the perioperative period received adjunctive therapy