Small Animal Neuro Surgery

Question 1

You get this history from an owner of a dog - what condition comes to mind: “sudden crying out with neck pain, muscle spasms of the neck, fasiculations of the neck, clinical signs appear spontaneously, decrease in activity, later on only moving eyes to follow object, severe pain but mild proprioceptive defects”

Answer 1

Cervical intervertebral disk syndrome

Question 2

Which cervical disks have the highest incidence of protrusion?

Answer 2

C2-C3 and C3-C4

Question 3

How might you attemot to manage cervical intervertebral disk syndrome medically?

Answer 3

Strict cage rest (3-4 weeks), pred, dex, diazapam, cimetidine/sucralfate/misoprostol (prevent gastric ulcers from anti-inflammatory drugs)

Question 4

How would you approach cervical intervertebral disk syndrome surgically?

Answer 4

Ventral slot decompression +/- fenestration - remove protruded disk material from the spinal canal.

Question 5

What breeds typically suffer alanto-axial instability?

Answer 5

Small, toy breeds

Question 6

How can you treat alanto-axial instability?

Answer 6

Stabilization with wire (dorsal approach) or pins to cause fixation of the joint (ventral approach).

Question 7

Describe Hansen type 1 disc protrusion:

Answer 7

Total rupture of the annulus fibrosis with massive extrusion of the nucleus pulposis and massive trauma.

Question 8

Describe Hansen type 2 disc protrusion:

Answer 8

Partial rupture / bulging of the nucleus pulposis with slower onset.

Question 9

Describe the effect of the location of the spinal cord compression lesion:

Answer 9

In the cervical area the canal is wider - less pain and less severe. In the thoracolumbar region the canal is smaller - paresis/paralysis with worse prognosis.

Question 10

Is acute or chronic injury to the spinal cord worse?

Answer 10

Acute injury is worse. Chronic injury allows nerve fibres time to remodel and cope with the changes.

Question 11

What is cauda equina syndrome?

Answer 11

A complex of neurologic signs caused by compression of the cauda equina nerve roots coursing through the lumbosacral spinal canal.

Question 12

What is the prognosis for cauda equina syndrome post-surgery?

Answer 12

If the dog does not have urinary incontinence - good! If bladder control is gone - Bad!

Question 13

What spinal nerves supply the brachial plexus?

Answer 13

C6-T2

Question 14

What spinal nerves supply the radial nerve?

Answer 14

C7-T2

Question 15

Which nerve supplies the inner 3 toes on the hind limb?

Answer 15

Femoral nerve

Question 16

Which nerve supplies the outer 2 toes on the hind limb?

Answer 16

Ischiatic nerve