Neurology Flashcards
Bonelli and da Costa, JVIM, 2019:
What % were giant breed dogs?
Most common clinical signs?
Most common sites of compression?
What % had 2 or more sites of compression?
What were the most common cause(s) of compression?
What % had intervertebral disc degeneration?
80% giant breed dogs
Proprioceptive ataxia (90%), cervical pain (45%)
C5-6, C6-7 or both
60% had 2 or more sites of compression
Articular process proliferation (40%), disc protrusion (10%)
45% had intervertebral disc degeneration
Bok, Vet Surg, 2019:
Cervical fusion
What % improved?
What % subsidence was seen?
What % developed implant failure and what % required plate removal?
Long-term outcome?
89% improved
11% subsidence
44% developed implant failure, 22% required plate removal
Long-term outcome was good
Rohner, VCOT, 2019:
DACSM treated with C-LOX anchored intervertebral spacer
What % improved or had normal neuro exam at 3 months post-op?
Most common post-op complication?
Short-term outcome?
89% improved or had normal neuro exam at 3 months post-op
Screw loosening was the most common post-op complication, but only 5% had displacement of the implant
Good short-term outcomes
Saunders, Vet Surg, 2018:
Was there an association between a greater rostral projection of the sacral lamina and a diagnosis of DLSS?
Is the height of the vertebral canal at L7/S1 diagnostic or predictive of DLSS?
Risk factor(s) for development of cauda equina syndrome?
Saunders, Vet Surg, 2018:
No association between greater rostral projection of the sacral lamina and DLSS
Height of the vertebral canal at L7/S1 was neither diagnostic nor predictive of DLSS
Dogs >5 years of age had a greater risk of developing cauda equina syndrome
Zindl, Vet Surg, 2018:
Pedicle screw-rod fixation system
Effect(s) on motion at L7-S1 and L6-7?
Zindl, Vet Surg, 2018:
Significantly reduced primary and coupled motion at L7-S1 with a concomitant increase in motion at L6-7, which may suggest the potential for adjacent level effects
Worth, VCOT, 2018:
Effect(s) of lateral foraminotomy on volume of the LS lateral intervertebral neurovascular foramen?
Regrowth of bone at the foraminotomy site occurred despite having excellent outcomes - true or false?
Increased foraminal volume was still evident at long-term follow-up, but in 33% of those dogs, what was the % increase in foraminal volume compared to pre-op?
Worth, VCOT, 2018:
Lateral foraminotomy increased the volume of the LS lateral intervertebral neurovascular foramen to >7 times its initial volume
True
In 33% of the dogs, the long-term increase in foraminal volume was only 125% of the pre-op volume
Nel, Vet Surg, 2017:
Fixation of LS fracture-luxations with pins + PMMA or SOP plates provide similar stability - true or false?
Nel, Vet Surg, 2017:
True
Tran, Vet Surg, 2017:
Lateral vs dorsal stabilization of lumbar spinal fracture-luxations
Advantages and disadvantages of the lateral approach?
Tran, Vet Surg, 2017:
Advantages: superior for pin angle accuracy and bone purchase - clinically important consequences of breach are less common
Disadvantages: prevents observation of the articular facets
Fujioka, Vet Surg, 2019:
Patient-specific drill guide template
What % of screws were placed without vertebral canal invasion?
Was greater accuracy achieved for screws placed in the cranial lumbar or caudal thoracic vertebrae?
Fujioka, Vet Surg, 2019:
90% of the screws were placed without vertebral canal invasion
Greater accuracy of screw placement was achieved in the cranial lumbar vertebrae than the caudal thoracic vertebrae
Gallastegui, VRU, 2019:
What % of fractured vertebrae had complete agreement for exact fracture location between MRI and CT?
Gallastegui, VRU, 2019:
Complete agreement between MRI and CT was achieved in only 14-33% of fractured vertebrae
Schmidli, VCOT, 2019:
C2 fractures
What % only showed cervical pain?
What % had fractures involving the dens?
Chances for full or functional recovery with conservatively vs surgically managed cases?
Schmidli, VCOT, 2019:
32% showed only cervical pain
23% had fractures involving the dens
Chances of full or functional recovery were very good for both conservatively and surgically managed cases
Kohler, JAVMA, 2018:
Cytoreductive surgery for suspected primary intracranial masses
Mortality rate?
Major complication rate?
What factors were associated with development of major complications or death?
What % were non-tumorous lesions?
What factor was associated with the lowest survival rate?
Kohler, JAVMA, 2018:
13% mortality rate
19% major complication rate
Abnormal findings on pre-op neuro exam, dogs undergoing a suboccipital approach
8% were non-tumorous lesions
Dogs that developed aspiration pneumonia had the lowest survival rate
Forward, Vet Surg, 2018:
Post-op complication rate following intracranial surgery?
Most common post-op complication?
Forward, Vet Surg, 2018:
47% post-op complication rate
Aspiration pneumonia was the most common post-op complication
Nakano, Vet Surg, 2018:
Agreement between intensities and pattern of pre-op gadolinium enhancement on MRI and intra-op fluorescein sodium staining?
Nakano, Vet Surg, 2018:
Intensities and pattern of pre-op gadolinium enhancement on MRI agreed with intra-op fluorescein staining
MacLellan, JAVMA, 2018:
What was predictive of outcome - tumor grade or pre-op tumor volume?
MacLellan, JAVMA, 2018:
Tumor grade was predictive of outcome
Noyes, Vet Surg, 2017:
Size of planned laminectomy defects based on MRI vs CT?
Noyes, Vet Surg, 2017:
Size of planned laminectomy defects tended to be larger based on MRI compared to CT
Mathieson, Vet Surg, 2018:
Ventral stabilisation of thoracic kyphosis through bilateral intercostal thoracotomies and SOP plates
Post-op complications?
% improvement in neuro scoring long-term?
Mathieson, Vet Surg, 2018:
Seroma (33%), screw breakage (33%)
83% improved in neuro scoring long-term
Bertram, VRU, 2019:
Neurologically normal Frenchies, English Bulldogs and Pugs
Most common congenital vertebral malformation?
Most common congenital vertebral malformations by breed?
Bertram, VRU, 2019:
Lumbosacral transitional vertebrae most common (34%)
Frenchies: Hemivertebrae (32%), lumbosacral transitional vertebrae (26%)
English Bulldogs: Hemivertebrae (24%), lumbosacral transitional vertebrae (14%)
Pugs: Lumbosacral transitional vertebrae (54%)
De Decker, JVIM, 2019:
Most common location of kyphotic segment?
What factors are associated with higher likelihood of neurological disease?
What Cobb angle corresponds with the highest combined sensitivity and specificity to differentiate between clinically affected and unaffected dogs?
De Decker, JVIM, 2019:
Kyphotic segment most often centred at T7-8
-Pug breed
-more severe kyphosis
-fewer rather than more hemivertebrae
-ventrolateral hypoplasia hemivertebrae subtype
Cobb angle of 34.5 degrees
Schneider, VCOT, 2017:
Incidence of C2-3 anomalies in dogs with and without AAI?
Schneider, VCOT, 2017:
38% of dogs with AAI vs 12% of dogs without AAI
Leblond, VCOT, 2017:
Safety of implant placement is optimized by limiting implant diameter to what size in toy breed dogs?
Leblond, VCOT, 2017:
1.5mm
Leblond, VCOT, 2018:
Transarticular fixation using 2 screws vs multi-implant construct using 5 or 6 screws
Which screw(s) were the most successfully placed?
Which screw(s) were the most challenging to place?
Which constructs were more prone to failure?
Leblond, VCOT, 2018:
C2 pedicle screws in the 6-screw construct, but these screws would also inevitably result in vertebral artery injury
Monocortical screws in the C2 caudal vertebral body
The constructs using 2 screws were more prone to failure
Noyes, Vet Surg, 2017:
Planned laminectomy defects tended to be smaller or larger based on MRI compared to CT?
Noyes, Vet Surg, 2017:
Planned laminectomy defects tended to be larger based on MRI compared to CT
Chai, JAVMA, 2018:
What was associated with increased odds of IVDD in Pekingese?
Chai, JAVMA, 2018:
Presence of calcified discs in the T10-L4 region
greater body weight
female dogs
Hamilton-Bennett and Behr, Vet Surg, 2019:
Cats with IVDD treated with hemilaminectomy
What outcomes were achieved?
What % had dispersal of extruded disc material beyond the disc space evident on MRI?
What % had complete degeneration of the extruded disc and lateralization of the extruded disc material?
Hamilton-Bennett and Behr, Vet Surg, 2019:
50% excellent outcome, 17% good outcome, 17% poor outcome
83% had dispersal of disc material beyond the disc space
50% had complete degeneration of extruded disc and lateralization of disc material
Gordon-Evans, Vet Surg, 2019:
What is associated with a slower recovery post-op in Dachshunds that receive post-op rehab?
Gordon-Evans, Vet Surg, 2019:
Increased pre-op disability is associated with slower recovery but not body condition
Hermann, VCOT, 2018:
Standard ventral slot vs inverted cone slot vs slanted slot vs fenestration
Which procedure(s) increased the ROM of the C4-5 VMU?
Do the inverted cone slot and slanted slot provide any biomechanics benefit over the standard ventral slot?
Hermann, VCOT, 2018:
All procedures increased the ROM of C4-5 VMU
No benefit over standard ventral slot
Crawford and De Decker, VCOT, 2018:
Peri-op complication rate for hemilaminectomy + annulectomy vs hemilaminectomy + partial discectomy?
% early post-op neuro deterioration for hemi + annulectomy vs hemi + partial discectomy?
Median time to ambulation for hemi + annulectomy vs hemi + partial discectomy?
Recurrence rate for hemi + annulectomy vs hemi + partial discectomy?
Crawford and De Decker, VCOT, 2018:
27% vs 21%
55% vs 29%
7 days vs 4.5 days
50% vs 26%
Skytte and Schmokel, JAVMA, 2018:
Mean interval from surgery to regaining micturition?
Correlation between pre-op modified Frankel score and interval to regaining micturition?
Mean interval from surgery to regaining ambulation?
Correlation between pre-op modified Frankel score and interval to regaining ambulation?
What % regained micturition before ambulation and what % regained both at the same time?
What % developed UTI post-op?
Skytte and Schmokel, JAVMA, 2018:
4 days to regaining micturition
Negative correlation between pre-op modified Frankel score and interval to regaining micturition
14 days to regaining ambulation
Negative correlation between pre-op modified Frankel score and interval to regaining ambulation
52% regained micturition before ambulation, 37% regained both at the same time
17% developed UTI
Drury, Vet Surg, 2019:
Integrated endoscopic thoracolumbar hemilaminectomy
What sized lesions and in what locations were accessible?
What affected the size of the hemilaminectomy?
Drury, Vet Surg, 2019:
Lesions <70% the diameter of the cannula size and located with the area 1/3 cranial and 2/3 caudal to the center of the disc space could be accessed
Size of cannula used affected the size of the hemi
Nakamoto
Progressive Myelomalacia
Vet Surg 2021
Extensive hemilaminectomy & Durotomy = 100% survival
Woelfel
Paraplegia in Med-Large dogs
Vet Surg 2021
Factors independently associated with outcome included
- clinical severity = poor
- number of vertebrae with signal interruption in HASTEi = more extensive epidural hemorrhage
- ratio of vertebral sites decompressed to HASTEi = better
Fenn
Anesthesia duration and outcome
JVIM 2020
Median anesthesia time
Regain ambulation 4 h
Did not 4.5 h
Zidan
Long-term pain
JVIM 2020
15% chronic pain
others normalized by 6 months
Longo
MRI assessed disc degeneration recurrence in dogs tx for IVDD
JVIM 2021
Other degenerate disc at the time of surgery
hazard ratio of 2.92 for recurrence of CS
Bosch
Facetectomy on Biomechanics in C-spine
VCOT 2017
Facetectomy increased range of motion of primary motions in all directions.
Axial rotation was significantly influenced by facetectomy.
Schneider
Incidence of abnormalities of C-spine with AA Instability
VCOT 2017
The incidence of anomalies affecting the C2/3
- dogs with AAI was 38.46%
- control group it was 11.97%
The majority of the observed anomalies involved the intervertebral disc.
Crawford
Compare Hemilaminectomy with anulectomy or partial discectomy
VCOT 2018
Early postoperative neurological deterioration
HA group 16/29*
HPD group 7/24
Sustained clinical improvement
HA group 9/22
HPD group 17/23*
Clinical Significance Hemilaminectomy with partial discectomy for decompression of thoracolumbar intervertebral disc protrusion was associated with decreased postoperative neurological deterioration and increased sustained clinical improvement compared with hemilaminectomy with anulectomy.
Conte
T Vertebral Stenosis w/ Screw Tail
VCOT 2021
Stenotic ratio of 0.56 associated with clinical signs
Caraty
Tail avulsion
JSAP 2018
11/15 cats recovered voluntary tail function and pain sensation within 14 to 90 days (mean 39 days).
5/8 previously incontinent cats recovered urinary continence within a month of surgery.
Skytte
Pre-op neurologic score w/ intervals to regain micturition and ambulation
JAVMA 2018
regaining micturition was 4.1 d (3 at 2.9, 2 at 6)
regaining ambulation was 13.8 d (3 at 6.9, 2 at 28.8)
negative correlations with MFS were identified for interval to regaining micturition (r = –0.63) and interval to regaining ambulation (r = –0.64)
Tirrito
Agreement of Sx decompression and PO MRI
JAVMA 2020
The correlation between surgeons’ perception and postoperative MRI findings for the degree of spinal cord decompression achieved was only fair.
Unsatisfactory spinal cord decompression as assessed via postoperative MRI was associated with
~severity of preoperative neurologic grade
~preoperative compression, thoracolumbar (vs cervical) IVDE
~ventral (vs ventrolateral or dorsolateral) circumferential distribution of extruded material.
Satisfactory (vs unsatisfactory) decompression as assessed via MRI was associated with
~lower postoperative neurologic grade
~greater likelihood of a successful outcome
~lower mean recovery time.
Spence
MRI related to Body Weight
JAVMA 2021
IVDD
< 15 kg 94.7%
≥ 15 kg 58.4%
Dogs weighing < 15 kg had a significantly higher inci- dence of IVDD lesions in the T12-13 segment, compared with dogs weighing ≥ 15 kg.
Dogs weighing ≥ 15 kg were Neoplastic 11.9 times
FCE 7.4 times
Gomes JFMS 2020
Which site was affected in 50% of cases?
What was a characteristic MRI feature?
Most common Radiographic features of this condition?
The L7–S1 intervertebral disc space (IVDS) was affected in 7/14 (50%) cases.
Characteristic MRI features ~hyperintense nucleus pulposus signal
~involvement of adjacent vertebral endplates (n = 11/14 [79%])
~hyperintense neighbouring soft tissue
~presence of spondylosis deformans (n=10/14 [71%]).
Radiographs
~collapse or narrowing of the affected IVDS (80%)
~endplate erosion (60%)
Gillespie JFMS 2020
Thoracic vertebral canal stenosis in cats
Median age?
Improved with medical treatment?
Improved with surgical treatment?
Age 9y
Medical management 2/5 improvement
Sx 2/3 improvement
British shorthair over-represented
Gomes JFMS 2022
Median age of Discospondylitis?
Median duration of clinical sings?
All cats had what clinical sign?
Neurological dysfunction in what % of cats?
Antibiotic therapy for how long?
Median age?
~9 years
Median duration of clinical signs? ~3 weeks
All cats presented with
~spinal hyperaesthesia
Neurological dysfunction?
~64.7% of cats
Sustained antibiotic therapy
~3 months
Kerr JSAP 2021
What % of Frenchies returned for reoccurrence of IVDD extrusion?
Median time between surgery and reoccurrence of sings?
Localization of reoccurrence
What % of Frenchies returned for reoccurrence of IVDD extrusion?
51%
The median time between surgery and reoccurrence of signs?
9m 21 days
Localization of reoccurrence
-original TL: 5/29 cervical
-original cervical: 5/14 TL
Pfund JSAP 2022
Caudal lumber IVDD
Urinary continence recovered in what %?
Fecal continence recovered in what %?
Tail function recovered in what %?
Urinary continence recovered in what %?
86%
Fecal continence recovered in what %?
90%
Tail function recovered in what %?
87%
Argent JSAP 2022
Complete recovery after medical vs. surgical management in cervical IVDD
Overall recurrence
M vs S
In medically managed patients, location of recurrence
In surgically managed patients, location of recurrence?
80% of recurrence occurred in what time frame?
Significant difference in recurrence between M & S management?
Complete recovery after medical vs. surgical management
M: 30.3%
S: 69.7%
Overall recurrence
34%
M: 36%
S: 33%
In medically managed patients, the location of recurrence
-occurred at the same site
In surgically managed patients, the location of recurrence
-occurred at an adjacent site
80% occurred
-within 2 years of diagnosis
A significant difference in recurrence between M & S management?
NO
Murthy JVIM 2021
In serum phosphorylated neurofilament heavy chain (pNF-H) in progressive myelomalacia dogs with T/L IVDD, dogs that developed PMM had an elevation at what time point?
What concentration was associated with identifying PMM?
Dogs that developed PMM had significantly higher serum pNF-H concentrations after surgery compared to all other cohorts at 24 hours: 39.88 ng/mL
≥31.39 ng/mL was 83.33% sensitive and 100% specific for identifying PMM in this cohort
McBride JVIM 2022
Odds of spinal shock decreased with?
Odds of spinal shock decreased with
-increased weight
-increased duration
-decreased pelvic limb tone
-increased presence of paraplegia
Johnson JVIM 2022
Hydromyelia is associated with what in IVDD?
Chronicity
Bridges JVIM 2022
Which breed was overrepresented for dic-associated epidural hemorrhage?
What clinical signs were associated with EH?
What MRI findings were associated with EH?
Location in Frenchies?
Which breed was overrepresented for dic-associated epidural hemorrhage?
-Frenchies
What clinical signs were associated with EH?
-less than 48h of signs
-more likely non ambulatory
What MRI findings were associated with EH?
-<50% cross-sectional SC compression
-longer compression (3 vs 1 space)
-greater intrinsic SC change
Location in Frenchies?
T/L
Dongaonkar Vet Surg 2021
T/F: Intermittent bolus irrigation was associated with lower peak vertebral canal temperatures than continuous irrigation
True
Schmitt Vet Surg 2021
Vertebral corridors width?
Widest corridor at?
Corridor length?
Shortest corridor?
Longest corridor?
Vertebral corridors width
3.8-5.2 mm
Widest corridor
T1
Corridor length
13.3 to 17.5 mm
Shortest corridor
T1
Widest corridor
T6
Falconer-Hall VCOT 2021
Disc Fenestration
Neurologist more likely than surgeons
41% complication rate- hemorrhage
Discospondylitis
common signalment
Breed:
Great Dane
Lab
Rotti
GSD
Dobi
English Bulldog
Male>Female
Young to Middle-aged
Common sites for discospondylitis
Caudal cervical
Mid-thoracic
Thoracolumbar
Lubosacral intervertebral disk
The most common concurrent condition in dogs with discospondylitis
UTI
Organisms associated with discospondylitis
Staphylococcus
E. coli
Radiographic progression of discospondylitis
-Initial narrowing of IVD space
-Focal lysis of vertebral end plates
-Finally marked lysis, sclerosis and spondylosis
MRI changes with discosponylitis
T2 hyper intensity
T1 hypo intensity
Contrast enhancement w/in IVD, vertebral body end plates, soft tissue ventral to vertebral body and epidural fat
Additional diagnostics with discosponylitis to find causative agent
Urine culture
Blood culture
Echocardiogram
TxR
Fungal culture in GSD
White et al VetSurg 2019
What is the best flexed angle on lateral radiographs to diagnose AA instability?
51 degrees of flexion
90% sensitive and 90% specific
Schneider et al VCOT 2017
What is the most common concurrent abnormalitiy associated with AA instability?
IVD anomalies (33.34% of dogs)
Noyes et al VetSurg 2017
What are the difference made when planning hemilaminectomies using CT vs MRI?
- Lots of variation in surgical location and size
- Would plan a different overall approach ~50% of the time between the two modalities
-Side of approach was most consistent between the two modalities
Dixon et al JAVMA 2017
What were the conclusions regarding anesthesia related hypotension and oucome of dogs with IVDD?
- 60% of patients experieinced hypotension
- Regaining motor or urinary function not associated with occurence of hypotension, duration or severity of hypotension
Zidan et al JVIM 2020
What percentage of dogs with spinal cord injury will develop chronic neuropathic pain?
15%
Dyall et al VCOT 2018
What is the SSI rate for dogs undergoing hemilaminectomy without perioperative antimicrobials?
0.6%
Mari et al JVIM 2019
What are the risk factors/predictors of urinary or fecal incontinence in dogs with TL ANNPE?
- paraplegia
- intramedullary hyperintensity >40% of cross sectional area of the spinal cord
- No NSAID treatment
- Clinical signs of spinal shock
Skytte et al JAVMA 2018
What is the average time to regain micturition and ambulation after TL decompression surgery?
- Micturition 4.1 days
- Ambulation 13.8 days
Nessler et al JVIM 2018
What was the conclusion regarding prognosis for medical vs surgical treatment of hydrated nucleus pulposus extrusion in dogs?
Medical management and Sx have equivocal outcomes
*Lesion relative to length of C3 = longer lesion = more dogs died acutely, less likely to have functional outcome
Crawford et al VCOT 2018
Which method had a better clinical outcome when combined with a hemilaminectomy - annulectomy vs partial discectomy?
Partial discectomy
Annulectomy - more patients had acute neuro deterioration after surgery
Alisauskaite et al JVIM 2019
What is the outcome of pugs treated surgically for T-L spinal arachnoid diverticula?
Good improvement in the short term (80%)
Poor long term outcome (86% deteriorated)
De Decker JVIM 2019
What findings related to hemivertebrae are assoaciated with clinical signs in Frenchies, Pugs and English Bulldogs?
-Pug breed
-More severe kyphosis
-fewer hemivertebrae
-Ventrolateral hypoplasia hemivertebre
All associated wtih higher likelihood of neurological disease
Stabilizers of the vertebral column
Body:
Buttress to resist bending and axial loading
Articular process:
resists all forces
IVD:
rotation
lateral bending
Funkquist A
Remove:
Spinous process
Laminae
Articular processes
1/2 dorsal portion of pedicles
Funkquist B
Remove:
Spinous process
Laminae
Leave articular process & pedicles
Modified dorsal laminectomy
Remove:
Laminae
Spinous process
Caudal articular process
Cranial articular process remain
Radiographic features of disc herniation
-Narrowing of IVD space
-Wedging of IVD space
-Increased articular process overlap
-Mineralized material superimposed over intervertebral foramen or vertebral canal
reduced intervertebral foramen diameter
Factors that positively affect performance of CT for IVDD
-Multiplaner reconstruction techniques
-Chronic history of IVD herniation
-Chondrodystrophic breed type
-Presence of mineral dense IVD
Innervation of bladder
Pelvic n
-Parasympathetic S1/S3
*detrusor m. contraction
Pudendal n
-somatic innervation *external urethral sphincter relax
Hypogastric n
-sympathetic
*internal urethral sphincter contract (alpha)
*detursor relax (Beta)
Modified Frankel Score
0: Tetraplegia w/ No DP
1: Tetraplegia w/ superficial pain
2: Tetraplegia w/ nociception
3: Non-ambulatory tetraparesis
4: Ambulatory tetra paresis
5: Hyperesthesia
Patellar Reflex
L4/L6
Biceps Reflex
C7/T2
W/d FL
C6/T2
W/d HL
L6/S1
Perineal Reflex
Sacral n. & Pudendal n.
S1-3
Paresis/ Plegia
Paresis- voluntary motor
Plegia- no motor
Nerve Damage Scale
I: interrupt fnx not structure (neuropraxia)
II: axon damage, endometrium intact (axontmesis)
III: axon and endometrium injury (neurotmesis)
IV: perineurium damaged (neurotmesis)
V: severed (neurotmesis)
Phrenic n
C5/7
Anticlinal vertebrae
T10
Intervertebral disc anatomy
Annulus fibrosus
Nucleus pulposus
Cartilaginous end plate
Dorsal compartment of vertebral canal
-Spinous Process
-Vertebral Laminae
-Articular Process
-Vertebral Pedicles
-Dorsal Ligament
Middle compartment of vertebral canal
-Dorsal Longitudinal Ligament
-Dorsal Portion of Annulus
-Dorsal Vertebral Body
Ventral compartment of vertebral canal
-Vertebral Body
-Lateral and Ventral Portion of Anulus
-Nucleus Pulposis
-Ventral Longitudinal Ligament
Spinal Fracture Ex Fix Type
Type 1 or 1b
Hounsfield units
Air Fat Water Brain Acute Clot Bone/Mineral Metal
Substances with high signal on T1
Fat Methemoglobin Protein binding Gadnium Melanin
Substances with high signal on T2
CSF Edema Necrosis Inflammation Demyelination
Abs with good BBB penetration
3rd Generation Cephlasporin Fluoroquinolones Metronidazole Sulfonamides Chloramphenicol Trimethoprim
Surgery for AA lux Dorsal approach
AA wiring
Nuchal Ligament
Dorsal Cross Pin
Kishigami AA Tension Band
Surgery for AA lux Ventral approach
Transarticular screws or pins - 30 degrees
Pins & PMMA - 30 degrees
Screws & PMMA - 90 degrees
Ventral Plating
Cervical IVDD Sx Tx
Ventral Slot Slanted Ventral Slot Dorsal Laminectomy Limited Dorsolateral Approach for Hemilaminectomy Fenestration
Complications associated with Cervical Sx
Respiratory Compromise Intraoperative Cardiac Dysrhythmias Blood Loss Neurologic Deterioration Ventral Instability and Subluxation Seroma Formation
Components of Disc Associated Spondylomyelopathy
Ventral compression by disc protrusion
Dorsal compression hypertrophy of dorsal longitudinal ligament and yellow ligament
Asymmetric disc protrusion causing compression of SC and nerve root compression
Components of Osseous Associated Spondylomyelopathy
OA proliferation of articular process
Dorsal hypertrophy of yellow ligament
Components of the Lumbar Intumescence
L4/6- Femoral n. L6/S1- Sciatic n. S1/3- Pelvic n. S1/3- Pudendal n. Cd1/5 Caudal n.
Function of Femoral n.
Flex hip
Extend Stifle
Function of Sciatic n.
Extend Hip
Flex Stifle
Flex/ Ext Tarsus
Components of LS Stenosis
Bulging annulus & nucleus pulpous Thinking of dorsal annulus Spondylosis deformans Osteophyte within caudal ventral foramen Thickening of joint capsule & zygapophyseal joint Thicking of the yellow ligament
Position that exacerbates LS Herniation
Extension
Postion that alleviates LS Herniation
Flexion
Horner’s syndrome associated with Cervical Spine
C6/T2
Disc Associated Spondylomyelopathy Distraction-Stabilization
Pins & PMMA Screw Bar- PMMA PMMA Plug Locking Place Disc Arthroplasty
Complications associated with Wobler Sx
Neurologic Deterioration ~Dorsal 70% ~Ventral 42% Vertebral Foramen & Transverse Foramina Penetration 25-57% Domino Effect 20% Laminectomy Membrane 8% Implant Failure 7-30% Collapse of Intervertebral Foramina Insufficient Decompression
Fixation of Lumbar Fx/ Lux/ Sublux
Pin & PMMA - 30-60 degrees
External Fixator
SOP Plates
Fixation of Cervical Fx/ Lux/ Sublux
Screws & PMMA
Unilock System
