Principles of Lumbosacral Disease Flashcards
Where in the spinal cord would a lesion for an animal to be tetra or para plegic/paretic?
Tetra - C1 - C5 or C6 -T2
Para - T3-L3 or L4-S3
What are the signs of LMN and UMN dysfunction?
LMN - decreased reflexes and muscle tone
UMN - normal/increased reflexes and muscle tone
What anatomy is affected in cauda equina syndrome?
L4 - Caudal nerve roots
What becomes dysfunction in cauda equina syndrome?
Tail
Urinary and anal sphincters
Bladder
Pelvic limbs
Which reflexes test the femoral, sciatic and pudendal nerves?
Femoral - Patella
Sciatic - Withdrawal
Pudendal - Perineal
What are the differential diagnosis for lumbosacral disease?
Degenerative lumbosacral syndrome Intervertebral disc degeneration Discospondylitis Myelitis Neoplasia Iliopsoas muscle injury
What causes degeneratice lumbosacral stenosis?
Multifactorial –> Soft tissue and bony changes –> Narrowing of SC canal in lumbosacral area
What animals are predisposed to DLSS?
Older
Large breeds (GSD)
Active/working dogs
LS malformations
What are the clinical signs of DLSS?
Lumbosacral pain Pelvic limb lameness Paraparesis/ataxia Low tail carriage, flaccid tail Urinary/faecal incontinence
What results are expected on orthopaedic exam of a DLSS case?
Pain on direct lumbar spinal palpation
Pain on hip extension
How are limbs affected by L4-S3 myelopathy?
Thoracic - Normal
Pelvic - LMN signs
How is DLSS diagnosed?
Clinical signs
Imaging
+/- Electrodiagnostics
What are the most useful imaging techniques for lumbosacral disease?
Radiography
CT
MRI
What are the signs of DLSS on CT?
Displacement of the epidural fat
How is DLSS treated medically?
Restricted activity NSAIDs Analgesia Neuromodulatory drugs Epidural steroids
