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Y4 - Small Animals > Spinal Disease > Flashcards

Spinal Disease Flashcards

1
Q

What are the grades of spinal disease?

A
  • Grade 1 = no deficits, just pain
  • Grade 2 = paresis, ambulatory
  • Grade 3 = paresis, non-ambulatory
  • Grade 4 = paralysis
  • Grade 5 = no pain sensation
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2
Q

What can cause peracute onset spinal problems?

A
  • Vascular =
    -Fibrocartilagenous Embolism (FCE) (dogs) = non-painful, v lateralised
    -Stroke (cats)
  • Trauma =
    -Acute non-compressive annulus pulposus extrusion (ANNPE) = following RTA / fall from height, non-painful, non-progressive herniation of pulposus
    -Fractures / luxations
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3
Q

What is treatment of FCE + ANNPE?

A
  • NOT SURGERY
  • supportive care + physio
    -median time to ambulation = 2wks
    -time to maximal recovery = 3months
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3
Q

What can cause fractures + luxations? How are they diagnosed?

A
  • Causes = RTA, bite wounds, falling from height
  • Dx = neuro exam, orthogonal radiographs, CT/MRI
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4
Q

What is treatment of fractures / luxations? Prognosis?

A
  • Initial tx = stabilise trauma + analgesia
  • Conservative vs surgical tx
    -if unstable = surgery / splint
    -if fragments compressing spinal cord = surgery
    -if transporting patient = splint
  • If lack of deep pain perception = v poor prognosis = spinal cord laceration
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5
Q

What can cause acute / subacute onset spinal problems?

A
  • IVDD type 1 (extrusion) - intervertebral disc degen.
  • Infectious / inflammatory
    -SRMA (steroid responsive meningitis-arteritis)
    -Discospondylitis
    -Spinal MUO
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6
Q

What occurs with chondrodystrophic breeds vs non-chondrodystrophic breeds of disc disease?

A
  • Chondrodystrophic breeds =
    -<2y/o
    -chondroid metamorphosis
    -IVD dehydrates + nucleus is invaded by hyaline cartilage, nucleus can mineralise
  • Non-chondrodystrophic breeds =
    -after middle age
    -fibroid metamorphosis
    -IVD dehydrated + nucleus is invaded by fibrocartilage; mineralisation less common
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7
Q

What is IVDD type 1? (extrusion)

A
  • Herniation of nucleus pulposus through annular fibres + extrusion of nuclear material into spinal canal
  • Peracute /acute + progressive
  • Painful
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8
Q

What is IVDD type 2 (protrusion)?

A
  • Annular protrusion caused by shifting of central nuclear material
  • Slowly progressive + chronic onset
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9
Q

What is Tx of IVDD?

A
  • Conservative = strict rest 4-6wks, analgesia
  • Surgical if =
    -severe neuro deficits
    -severe / recurrent pain
    -lack of improvement
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10
Q

What is Steroid responsive meningitis-arteritis? CS? Dx? Tx?

A
  • Most common cause of neck pain in young dogs - immune mediated
  • CS = lethargy, anorexia, fever, cervical rigidity, spinal pain, concurrent IMPolyArthritis
  • Dx = CSF analysis =
    -neutrophilic pleocytosis (acute)
    -mononuclear pleocytosis (chronic)
    -Spinal radiographs, CT, MRI
  • Tx = corticosteroids for 6-9m
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11
Q

What is discospondylitis? Dx? Tx?

A
  • Infection of IVD + adjacent vertebra
  • Pain !!
  • Dx = radiography, MRI / CT
    -narrowing of IVD space, roughening of endplates, proliferation of adjacent bone
    -bacteriology - blood/urine
  • Tx = antibiotics (+8wks) + analgesia
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12
Q

How is meningomyelitis of unknown origin diagnosed / treated?

A
  • Dx = MRI, CSF tap
  • Tx = corticosteroids
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13
Q

What are chronic onset spinal problems?

A
  • Neoplasia
  • Degenerative = IVDD type II, CSM, LSDS, DM
  • Anomalous = spinal malformation, CM/SM, AA instability
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14
Q

What is treatment of spinal neoplasia?

A
  • Decompressive surgery
  • Radiation
  • Palliative
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15
Q

What is cervical spondylomyelopathy (csm)? Causes? Tx?

A
  • Signs worse in pelvic limbs, shorted stilted gait + muscle atrophy
  • Causes =
    1. protrusion of IVD (type II IVDD)
    2. hypertrophy of ligamentum flavum and dorsal longitudinal ligament
    3. hypertrophy of synovial membrane
    4. stenosis of spinal canal
    5. degenerative joint disease of facets
  • Tx =
    -conservative = anti-inflammatories + rest
    -surgical = decompression / distraction stabilisation
16
Q

What is seen with lumbosacral degenerative stenosis (LSDS)? Causes? Tx?

A
  • CS =
    -reluctance to exercise, rise, jump into car, do stairs
    -lameness – nerve root signature (L7)
    -lumbosacral pain
    -monoparesis/paraparesis
    -proprioceptive deficits, reduced withdrawal reflex, muscle atrophy
    -urinary and/or faecal incontinence
  • Causes =
    1. type II IVDD
    2. sclerosis of vertebral endplates and articular processes
    3. hypertrophy of ligaments
    4. hypertrophy of synovial membranes
    5. foraminal stenosis
    6. ventral subluxation of sacrum
  • Tx =
    -conservative = anti-inflammatories + gabapentin
    -surgical = dorsal laminectomy, dorsal fusion-fixation, foraminotomy
17
Q

What are vertebral + spinal anomalies?

A
  • Spinal arachnoid diverticulae (SAD)
  • Butterfly vertebrae
  • Block vertebrae
  • Transitional vertebrae
  • Hemivertebrae
  • Spinal stenosis
18
Q

What is degenerative myelopathy?

A
  • insidious, progressive ataxia and paresis of pelvic limbs, ultimately leading to paralysis (over 6-18m)
  • T3-L3 myelopathy
  • usually asymmetrical
  • not painful
  • NO TREATMENT
19
Q

What is atlantoaxial instability? CS? Tx?

A
  • young dogs, Toy breeds
  • acute or chronic, often waxing /waning
  • associated with aplasia/hypoplasia of dens in Toy breeds and sometimes with trauma
  • Clinical signs =
    -neck pain
    -ataxia or tetraparesis
  • Tx =
    -conservative splint for 6-12 weeks: ~60% success
    -surgical (ventral stabilisation)
20
Q

What is chiari-like malformation?

A
  • mismatch between caudal fossa volume and its contents (cerebellum and brainstem) with caudal displacement of the cerebellum through foramen magnum
  • Hydromyelia – dilatation of central canal
  • Syringomyelia – fluid filled cavitation
  • Syringohydromyelia - both
21
Q

What does chiari-like malformation cause? Tx?

A
  • CS =
    -Neck pain
    -Neck scratching
    -Torticollis / scoliosis
    -Thoracic limb weakness + atrophy
  • Tx =
    -medical = gabapentin, NSAIDs, furosemide, steroids
    -surgical = high recurrence rate
22
Q

What are different neurosurgery?

A
  • Hemilaminectomy = removal of half of vertebral arch (TL spine)
  • Dorsal laminectomy = removal of dorsal spinous process + laminae - IVDD, congenital malformation + neoplasia
  • Ventral slot = slot like opening ventrally through IVD + cranial + caudal endplates of cervical vertebrae

Y4 - Small Animals (105 decks)

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