Spinal Disease Flashcards
What should you do when evaluating the intervertebral foramen
compare the shape and size to adjacent foramen
When evaluating individual vertebrae, what structures should you look at
1) Spinous process
2) accessory process
3) Mamillary processes (off cranial articular processes)
4) Cranial and caudal articular processes
5) Articular facet joint
6) Nice lucency between vertebral bodies
you should only evaluate the intervertebral disc space when
the disc space is in the center of the image
What might be differentials for a dog with back pain
-IVDD
-Discospondylitis
-Aggressive process?
-Trauma
-Soft tissue injury?
a benign conditon with questional clinical significance
may lead to back stiffness or be incidental
characterized by
1) smooth, well defined vertebral endplates
2) Smoothly marginated ventral bony proliferation +/- bridging
3) May narrow intervertebral space (with chronic degeneration)
Spondylosis deformans
With spondylosis deformans, when might you see narrow intervertebral space
with chronic degeneration
What 3 radiographic findings will you see with spondylosis deformans
characterized by
1) smooth, well defined vertebral endplates
2) Smoothly marginated ventral bony proliferation +/- bridging
3) May narrow intervertebral space (with chronic degeneration)
What can happen if spondylosis deformans matures
1) Bridge disc space
2) Become ankylosing and fuse the spine in extreme conditions
How many cervical vertebrae do dogs and cats have
7
How may thoracic vertebrae do dogs and cats have
13
How many lumbar vertebrae do dog and cats have
7
How many sacral vertebrae do dogs and cats have
3
if spondylosis is lateralized, what can occur
impingement of nerve roots
inflammation and/or infection of Intervertebral discs and adjacent vertebral body end plates
discospondylitis
what are the causes of discospondylitis
1) hematogenous infection is most common
due to UTI, dental disease, endocarditis, etc.
2) Migrating plant awn
3) Penetrating wound
4) Previous surgery with local infection
What are the most common pathogens associated with discospondylitis
Staphylococcus species is most common (also see strep, e coli, fungal pathogens (aspergillus, blasto, coccidiodes)
screen for brucella canis due to zoonotic potential
T/F: discospondylitis osseous changes are not permanent after treatment
False- osseous changes are permanent, should remodel to smooth bone instead of irregular margins
Sclerosis often remains
where the annulus fibrosus can degenerate, allowing movement of the nucleus into the spinal canal
higher incidence in chondrodystrophic breeds
intervertebral disc disease
What becomes calcified with IVDD
the nucleus pulposus
T/F: all mineralized discs will cause spinal cord impingement
False- need advanced imaging to determine clinically significant site
What are the radiographic signs seen with IVDD
1) Calcification of the nucleus of IVD
2) Narrowing of IV disc space
3) Increased opacity of IV foramen
4) Change in shape/size of IV formen
5) Narrowing of articular facet joints
6) Formation of ventral spondylosis deformans in chronic cases
what zoonotic disease can cause discospondylitis
brucella canis
How do you distinguish spondylosis vs discospondylitis
discospondylitis has irregular endplates due to destruction/lysis of the vertebral endplates. these appear narrowed
spondylosis: smooth marginated ventral body and vertebral end plates are well designed
How do we treat discospondylitis
treat with antibiotic and take repetetive radiographs
What should you do if you notice malalignment of the spine from trauma
spinal cord injury is applied but extent and severity requires neurological exam
often involves fractures and luxation
typically recommend stabilization surgery as long as spinal cord damage can be managed
How might you not need any views of the spine to make a diagnosis and one lateral view is all you need
some trauma patients with spinal fracture and luxation- this provides all the info we need to make a diagnosis
complete disruption stabilizing ligaments
luxation
aggressive spinal lesions
1) Neoplasia: primary, metastatic, diffuse/multicentric
2) Infection: bacterial and fungal
you notice a focal decrease in vertebral opacity, what is the likely diagnosis
likely neoplasia (less likely to be infection)
If solitary vertebra, think primary neoplasia but look for metastic disease
What can the focal decrease in vertebral opacity seen in neoplasia lead to
pathological fracture
What spinal radiological findings will you see with neoplasia
focal decrease in vertebral opacity
focal increase in vertebral opacity
When might you see focal increase vertebral opacity of a signle vertebra
1) Chronic compression fracture
2) Osteomyelitis
3) Neoplasia
4) Possibly degenerative change
Neoplasia’s characteristics of aggressive bone disease
1) focal ubcrease ub vertebral opacity
2) irregular periosteal proliferation
3) areas of lysis
4) long zone of transition
what are your differentials for multifocal decrease in vertebral opacity (ie multiple vertebrae affected)
1) Metastasis (Osteosarcoma, carcinoma)
2) Multiple myeloma
