LUMBOSACRUM: 33

Question 1

Cauda equina start before in large breed than small breed. T or F

Answer 1

T (L4 large, L6-7 small-toy+cats)

Question 2

L7 is part of cauda equina. T or F

Answer 2

F: S1, S2, S3 are considered cauda, L7 not formally included

Question 3

abnormalities potentially assiciated with cauda equina syndrome:

Answer 3

1) Hansen type II (less commonly type I) IVDH
2) transitional vertebrae
3) congenital osseous stenosis
4) sacral osteochondrosis
5) proliferation of the joint capsules or ligaments
6) osteophytosis of the articular processes
7) epidural fibrosis
8) instability or malalignment/subluxation
9) Synovial and ganglion cysts
10) epidural lipomatosis
11) congenital malformations

Question 4

name one important mechanism in induction and evolution of neurophatic pain

Answer 4

citokine upregulation

Question 5

name some examination techniques described to elicit lumbosacral pain

Answer 5

(1) applying traction or extension to the tail
(2) direct pressure
(3) direct pressure (thoracic limbs elevated)
(4) direct pressure (pelvic limbs elevated) (lordosis test)
(5) direct pressure (one limb at a time)
(6) rotating the lumbosacral articulation by swinging the pelvic limbs from side to side.

Question 6

clinical sign associated to sciatic nerve disfunction

Answer 6

1) failure of hock extensions during flexor-withdrawal test
2) patellar hyperreflexia (loss caudal tight antagonistic muscle tone)

Question 7

orthopedic differentials of LSS

Answer 7

1) bilateral cranial cruciate ligament disease
2) hip dysplasia
3) psoas muscle injury
4) gracilis and semitendinosus muscle contracture
(iliac artery thromboembolism)

Question 8

Where is the most common area of sacrum OCD?

Answer 8

dorsal and proximal aspect of the sacrum body

Question 9

Prognosis of medical treatement in dogs with DLSS

Answer 9

55% managed conservatively (NSAID, gaba). 4-6 week restricted activity

Question 10

Additional procedures associated with dorsal laminectomy of L7-S1

Answer 10

1) partial discectomy (dorsal fenestration or nuclear pulpectomy)
2) foraminotomy
3) removal zygoapophyseal joint

Question 11

dorsal laminectomy dorsal limits

Answer 11

cranio-caudal: until normal nervous tissue is seen
latero-lateral: medial articular processes

Question 12

Name from lateral to medial nerve roots encountered in LS junction

Answer 12

S1, S2, S3

Question 13

What is necessary to do to be able to perform a lateral approach to L7 S1 foramina?

Answer 13

ilium osteotomy (gluteal, sratorius release)

Question 14

study demonstrated that ……. of dogs undergoing surgery for degenerative lumbosacral stenosis had positive bacterial cultures of the degenerative intervertebral disc material

Answer 14

23%

Question 15

preoperative factors associated with poorer prognosis after LSS surgery

Answer 15

1) fecal and urinary incontinence
2) duration of urine incontinence (longer 1 month)

Question 16

preoperative factors associated with better prognosis after LSS surgery

Answer 16

as age and severity of clinical sign increase, better outcome following surgery